BLA 081: Tendinopathy 101 (Pathology, Diagnosis, Presentation, Treatment)

If you are active, or take care of people who are active, then you have probably heard of the term tendinitis. That term is a little out of date as I’ll explain in a little bit here, but it proves the point that tendon problems are very common. Today, we’ll talk all about them so let’s dive in.

CHAPTERS:

00:00 - Introduction

00:36 - Anatomy and Biomechanics

03:35 - Pathophysiology of Tendinopathy

05:24 - Concept of Load

06:01 - Tendon Pathology Model

10:08 - Donut Hole Model

11:08 - Locations of Tendinopathies

11:42 - Clinical Categories

12:26 - Clinical Presentation

14:25 - Imaging

16:33 - Pain Doesn’t Correlate With Imaging

17:35 - Treatment

20:10 - Exercise Therapy

21:40 - Summary

22:06 - Outro

References:

Abramoff, B., & Caldera, F. E. (2020). Osteoarthritis: Pathology, Diagnosis, and Treatment Options. The Medical Clinics of North America, 104(2), 293–311. https://doi.org/10.1016/j.mcna.2019.10.007

Ahmad, Z., Parkar, A., Shepherd, J., & Rushton, N. (2020). Revolving doors of tendinopathy: Definition, pathogenesis and treatment. Postgraduate Medical Journal, 96(1132), 94–101. https://doi.org/10.1136/postgradmedj-2019-136786

Cook, 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.2008.051193

Cook, J. L., Rio, E., Purdam, C. R., & Docking, S. I. (2016). Revisiting the continuum model of tendon pathology: What is its merit in clinical practice and research? British Journal of Sports Medicine, 50(19), 1187–1191. https://doi.org/10.1136/bjsports-2015-095422

Docking, S. I., & Cook, J. (2016). Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC). Scandinavian Journal of Medicine & Science in Sports, 26(6), 675–683. https://doi.org/10.1111/sms.12491

Docking, S. I., & Cook, J. (2019). How do tendons adapt? Going beyond tissue responses to understand positive adaptation and pathology development: A narrative review. Journal of Musculoskeletal & Neuronal Interactions, 19(3), 300–310.

Maffulli, N., Nilsson Helander, K., & Migliorini, F. (2023). Tendon appearance at imaging may be altered, but it may not indicate pathology. Knee Surgery, Sports Traumatology, Arthroscopy. https://doi.org/10.1007/s00167-023-07339-6

Mead, M. P., Gumucio, J. P., Awan, T. M., Mendias, C. L., & Sugg, K. B. (2018). Pathogenesis and Management of Tendinopathies in Sports Medicine. Translational Sports Medicine, 1(1), 5–13. https://doi.org/10.1002/tsm2.6

Millar, N. L., Silbernagel, K. G., Thorborg, K., Kirwan, P. D., Galatz, L. M., Abrams, G. D., Murrell, G. A. C., McInnes, I. B., & Rodeo, S. A. (2021). Tendinopathy | Nature Reviews Disease Primers. Nature Reviews Disease Primers, 7(1), 1. https://doi.org/10.1038/s41572-020-00234-1

Scott, A., Squier, K., Alfredson, H., Bahr, R., Cook, J. L., Coombes, B., de Vos, R.-J., Fu, S. N., Grimaldi, A., Lewis, J. S., Maffulli, N., Magnusson, S. P., Malliaras, P., Mc Auliffe, S., Oei, E. H. G., Purdam, C. R., Rees, J. D., Rio, E. K., Gravare Silbernagel, K., … Zwerver, J. (2020). ICON 2019: International Scientific Tendinopathy Symposium Consensus: Clinical Terminology. British Journal of Sports Medicine, 54(5), 260–262. https://doi.org/10.1136/bjsports-2019-100885

Disclaimer

This video is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat , or prevent any condition. The information presented here was created with an evidence based approach, but you please keep in mind that science is always changing and at the time of listening to this there may some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified health care provider for questions regarding any medical condition.