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Tendon pain is often treated as a purely physical problem. Strengthen the tendon, adjust the load, and eventually things should improve.
But what happens when the pain persists for monthsā¦ or even years?
In this episode, Brodie speaks with physiotherapist and PhD researcher Jack Mest about a recent systematic review and meta-analysis exploring the psychological profile of people with persistent tendinopathy. The research compared people with chronic tendon pain to healthy controls and uncovered something surprising: fear of movement wasnāt the main psychological factor.
Instead, the research found that pain catastrophizing ā a negative outlook toward pain and recovery ā appeared more common in people with persistent tendinopathy.
This episode explores how psychological factors may influence tendon pain, why lower limb injuries may carry a greater psychological burden, and why clinicians need to treat the person behind the injury ā not just the tendon itself.
If youāre a runner struggling with Achilles pain, plantar fasciopathy, proximal hamstring tendinopathy, or another persistent tendon injury, this conversation will help you understand why recovery can feel so frustrating ā and what might help.
In This Episode
Brodie and Jack discuss:
- Why tendinopathy often becomes a chronic condition
- What the biopsychosocial model means for tendon rehab
- The difference between kinesiophobia (fear of movement) and pain catastrophizing
- Why catastrophizing appears more common in persistent tendon pain
- Why lower limb tendinopathies may have greater psychological impact than upper limb injuries
- The role of beliefs, expectations, and past experiences in shaping pain
- Why clinicians should ask about patientsā thoughts and fears about their injury
- Whether psychological traits are pre-existing or develop after chronic pain begins
- Practical advice for runners dealing with long-term tendon pain
About the Guest
Jack Mest is a physiotherapist and PhD researcher whose work focuses on understanding why tendinopathy becomes chronic and how psychological factors influence tendon pain.
His research aims to improve the way clinicians approach tendon rehabilitation by integrating biological, psychological, and social factors into treatment.
Follow Jack's research and updates:
Ā X (Twitter): @Mest_Jack
Facebook: Jack Mest Physio
Paper summary: https://www.jospt.org/do/10.2519/jospt.blog.2026017/full/Ā
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MEDICAL & EDUCATIONAL DISCLAIMER
The information provided in the Overcoming Proximal Hamstring Tendinopathy (PHT) Podcast, YouTube channel, associated websites, social media, and other educational content produced by Brodie Sharpe is provided for general educational and informational purposes only. It is not intended to constitute, and should not be relied upon as, individual medical, physiotherapy, diagnostic or treatment advice.
Although Brodie Sharpe is a qualified physiotherapist, consuming this content does not establish a physiotherapist-patient or other healthcare professional-patient relationship. Any discussion of symptoms, diagnoses, rehabilitation strategies, exercises, loading programs, running modification, medications, supplements, injections, medical procedures or other treatment options is general in nature and may not be appropriate for your individual circumstances.
Musculoskeletal pain can have multiple causes, and symptoms that appear consistent with proximal hamstring tendinopathy or another tendon disorder may arise from other conditions. Appropriate assessment, diagnosis and treatment depend upon an individual's medical history, symptoms, examination findings, medications, health conditions, training history and other factors that cannot be adequately assessed through general online content.
Do not use this content as a substitute for assessment, diagnosis or treatment from an appropriately qualified healthcare professional.Ā
Before starting, stopping or substantially modifying an exercise or rehabilitation program, medication, supplement, injection, procedure or other treatment discussed in this content, seek advice from an appropriately qualified healthcare professional who can consider your individual circumstances.
Exercise, rehabilitation and medical treatments carry inherent risks. These may include increased pain, symptom flare-ups, aggravation of an existing condition, new injury, adverse reactions or other complications. Individual responses vary and no particular outcome, improvement, recovery timeframe or return to sport can be guaranteed. If an activity or intervention causes significant, unusual or worsening symptoms, stop and seek appropriate professional advice.
References to research, clinical studies, treatment approaches, products or opinions of guests are provided for educational purposes. Scientific evidence evolves over time, may be incomplete or conflicting, and findings from research populations may not apply to every individual. Discussion of a treatment or product does not necessarily constitute an endorsement or recommendation for its use. Views expressed by podcast guests or other contributors are their own and do not necessarily represent the views of Brodie Sharpe.
To the extent permitted by applicable law, Brodie Sharpe and associated businesses, contractors and contributors accept no liability for loss, injury, damage or adverse outcomes arising from reliance upon or use of this general educational content. Nothing in this disclaimer is intended to exclude, restrict or modify any right, guarantee, remedy or liability that cannot lawfully be excluded, restricted or modified under applicable law.
If you believe you may have a serious injury or medical condition, or you develop severe, rapidly worsening or otherwise concerning symptoms, seek prompt assessment from an appropriately qualified healthcare professional. In an emergency, contact your local emergency service.