Tendon Pain, Injury, and Rehab

“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.
 
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?