Show notes
“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. Learn more about us here. 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?



