There are a range of tendinopathy presentations, from easily diagnosed with a local area of pain and clear pain response to tissue overload; through to patients with trickier presentations and multiple contributors to pain e.g. long term proximal hamstring or gluteal tendinopathy with a lumbar spine radiculopathy.
How can you diagnose and treat patients with complex tendinopathy presentations? How does the latest research around tendinopathy help us? I explore these issues and more with Dr Peter Malliaras in episode 68 of the Physio Edge podcast. We also explore:
- Do tendinopathy patients always present with a small area of pain, or can they have pain in larger, more diffuse areas?
- How will you identify tendinopathy or other structures that may be contributing to your patients symptoms?
- Clues in your patients' history to help you identify and differentiate tendinopathies, lumbar and SIJ referral
- Symptoms and how your treatment will differ in patients with paratenon and fat pad involvement
- How can you measure your patients load tolerance?
- What categories of tendinopathy patients can you use to help differentiate your treatment?
- How can you rehabilitate patients with tendinopathy?
- What role does biomechanics have?
- What advice can you provide to your patients about load management, symptoms and flareups?
- When is it ok for your patients to continue or return to running?
- What strength tests should your patients be able to complete before returning to running?
- If your patients are not tolerating running, which aspects should you modify first - frequency, intensity, type or duration?
- When are isometrics useful in your treatment?
- When can you start isotonic and plyometric exercises?
- How can you incorporate tendon neuroplastic training (TNT)?
Links associated with this episode
- Download your podcast handout
- Dr Peter Malliaras on Twitter
- Tendinopathy rehab blog with Dr Peter Malliaras
- Get your free trial Clinical Edge membership
- David Pope on Twitter
- Clinical Edge on Facebook
Other episodes of interest:
- PE 046 - Proximal hamstring tendinopathy with Tom Goom
- PE 042 – Treatment of plantaris and Achilles tendinopaty with Seth O’Neil
- PE 023 – Lower limb tendinopathies with Dr Pete Malliaras
Articles associated with this episode:
- Silbernagel et al. 2007. Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy.