Tendinopathy, Load, and the Path Back to Performance

The conversation delves into the complexities of tendinopathy, emphasizing the importance of understanding it as a load tolerance problem. It explores the continuum of tendinopathy, the role of mechanical loading in tendon response, and the need to restore capacity rather than just calm symptoms.This episode is designed for clinicians, coaches, students, and active individuals who want a deeper understanding of tendon rehabilitation from both a physiological and performance perspective.ReferencesBurton, I., & McCormack, R. (2022). Blood flow restriction training for tendinopathy rehabilitation: A potential alternative to traditional heavy-load resistance training. Journal of Sports Rehabilitation, 31(5), 611–620. https://doi.org/10.1123/jsr.2021-0204Cook, J. L., & Purdam, C. R. (2009). Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. British Journal of Sports Medicine, 43(6), 409–416. https://doi.org/10.1136/bjsm.2008.051193Docking, S. I., & Cook, J. (2019). Tendinopathy: Is imaging telling us the entire story? Journal of Orthopaedic & Sports Physical Therapy, 49(11), 842–852. https://doi.org/10.2519/jospt.2019.0610Kjær, M., Langberg, H., Heinemeier, K., Bayer, M. L., Hansen, M., Holm, L., Doessing, S., & Magnusson, S. P. (2009). From mechanical loading to collagen synthesis, structural changes and function in human tendon. Scandinavian Journal of Medicine & Science in Sports, 19(4), 500–510. https://doi.org/10.1111/j.1600-0838.2009.00986.xRio, E., Kidgell, D., Moseley, G. L., Gaida, J., Docking, S., Purdam, C., & Cook, J. (2015). Tendon neuroplastic training: Changing the way we think about tendon rehabilitation. British Journal of Sports Medicine, 50(4), 209–215. https://doi.org/10.1136/bjsports-2015-095215Rio, E., Kidgell, D., Purdam, C., Gaida, J., Moseley, G. L., Pearce, A. J., & Cook, J. (2015). Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy. British Journal of Sports Medicine, 49(19), 1277–1283. https://doi.org/10.1136/bjsports-2014-094386Silbernagel, K. G., Thomeé, R., Eriksson, B. I., & Karlsson, J. (2007). Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy. British Journal of Sports Medicine, 41(4), 276–280.https://doi.org/10.1136/bjsm.2006.033464Click here for the slide deck