Tendon Pain, Injury, and Rehab


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“Pain and pathology aren’t necessarily related. So you can have profound pathology, profound degeneration in your tendon and have no pain”

We speak with professor Jill Cook [PhD, Grad Cert Higher Ed, PG Dip Manips, BAppSci (Phty)] about tendon pathology, pain, and rehabilitation.

Visit LaTrobe University to contact or find out more about Jill Cook.

Learn more about us here.

00:25 Can you please introduce yourself?

00:54 Can you clarify the terminology for tendon pain? (tendinitis/tendinosis/tendinopathy)

02:01 Can you describe the structure of tendons and what makes them unique?

03:28 What happens with a tendon when there is injury?

04:28 If tendons do not recovery, how do people have success with physiotherapy and tendon loading?

05:15 Why are tendon injuries imaged?

06:39 How do you explain tendon pathology to a patient?

07:34 Are pathologic tendons more likely to rupture?

10:17 What are the differences in outcomes for surgery vs. non surgery with tendon ruptures?

11:25 Is surgery ever indicated for a tendinpathy?

12:31 In kids you don’t see many tendon ruptures, you usually see avulsion fractures first, why is this?

13:54 If there is tendon change with age, should older adults load their tendons less?

14:50 Is there anything that can be done to prevent age related changes in a tendon?

15:49 Are there any risk factors for tendon pathology?

16:46 How do you engage patients in a rehab program when research suggests exercise is the best treatment?

18:15 What are your thoughts on injectables? Do they change tendon structure at all?

19:54 What are your thoughts on shockwave therapy?

20:46 What about the role of manual therapy in tendon treatment?

22:16 Is there anything clinically that should not be done when treating a tendon injury?

23:56 How do you balance tendon load vs. pain with loading?

25:33 Is pain reduction a good indication of recovery?

26:51 What is the importance of the kinetic chain in tendon rehab?

28:26 Does all of the research for lower limb tendon injuries hold true for the upper limb as well?

29:40 If a tendon is overloaded, how can loading it change pain?

31:08 Is there a prognosis for tendon injuries in terms of how long it will take to improve?

32:28 For people with longstanding tendon pain, is it common for them to develop central sensitization?

32:28 What has been the evolution of tendon rehab and where do you see it going in the future?

35:25 Is there any inflammation with tendon pathology?

36:35 Why does rest not help with tendon recovery?

37:20 How comfortable are you pushing people into pain with loading?

38:18 How often do you suggest people load their tendons?

39:00 Why is heaving slow strength training so important in tendon rehab if it does not load the tendon?

40:14 What questions are you hoping to have answered with future research?

41:42 Where can people find out more about you?

33 episodes