“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?