Overcoming Tendonitis: A Systematic Approach to the Evidence-Based Treatment of Tendinopathy

Tendonitis is one of the most misdiagnosed and poorly understood injuries that athletes and workers may encounter in their lifetime. Even the word "tendonitis" itself is a misnomer because from the research we understand that tendinopathy is primarily a non-inflammatory proliferation disorder with minimal to no inflammation. It seems everyone has an opinion on what to do about tendinopathy from rest to ice to old wives tales to get this pesky injury to go away. This book seeks to change that by taking an in-depth look at one of the most commonly diagnosed orthopaedic conditions and provides a systematic approach to its resolution. Overcoming Tendonitis is a multi-faceted book that covers all topics related to tendinopathy from understanding the best available scientific research to relating the highly trained clinical rehabilitation experience its authors. It delves into the physiological understanding and process of tendinopathy to explain why the function and signs and symptoms of the tendon may differ between stages. It takes a look at the myths surrounding tendinopathy and the pain neuroscience education that can often make the rehabilitation process more complicated. It also gives guidance to patients and medical practitioners to comprehend an overview of the most scientifically accurate recommendations for treatment application. This book is a must-have manual for clinicians who are interested in comparing the efficacy of the multitude of interventions available in today's rehabilitation landscape. It is a useful tool for patients who are experiencing tendon issues and are in need of direction for their rehabilitation in conjunction with their physical therapist. If you or someone you know are one of the millions of individuals who has dealt with the confusing, frustrating, and painful diagnosis of "tendonitis," this book is for you. Introduction Chapter 1: UNDERSTANDING THE LEVELS AND CLASSIFICATION OF EVIDENCE IN STUDIES Overview of Levels and Classification of Evidence Overview of the Decision-making Process Chapter 2: UNDERSTANDING THE TENDINOPATHY PROCESS A Brief History of Tendinopathy Tendinopathy Models Tendinopathy Staging Intrinsic and Extrinsic Risk Factors Tendinopathy, Rehabilitation, and Outcomes Chapter 3: COMMON MYTHS OF TENDINOPATHY Rest Ice Analgesics Pain Blood Flow Chapter 4: TENDINOPATHY AND GENERAL REHABILITATION KNOWLEDGE Collagen Synthesis and Tendon Loading Frequency, Intensity, and Volume Eccentrics vs. Concentric-Eccentric Training Programming, Modifications to Activity, and Analysis of Current Research Chapter 5: PAIN AND TENDINOPATHY Pain Science Pain Education Tendinopathy Pain Managing Tendinopathy Pain with Isometrics Chapter 6: TENDINOPATHY PROGRAMMING, PROGRESSION, AND REHABILITATION Ordering of Rehabilitation and Prehabilitation Sample Rehabilitation Session Programming and Progression Alternative Protocols Rehabilitation Stages Continuing Your Sport During Rehabilitation Preventing Injury and Reinjury Chapter 7: TENDINOPATHY EXERCISES Rotator Cuff Golfer’s Elbow (Medial Epicondyle) and Anterior Wrist Tennis Elbow (Lateral Epicondyle) and Posterior Wrist Triceps Biceps Achilles Posterior Tibialis Patellar Hamstrings Chapter 8: OUTCOME MEASURES AND INTERVENTION CHARTS Tendinopathy Intervention Charts, Blurbs, Abbreviations, and Explanations Grade of Evidence MAJOR INTERVENTIONS Eccentric Loading and Exercise Therapy Corticosteroid Injections (CST) Extracorporeal Shockwave Therapy (ECST or ESWT) Low-Level Laser Therapy (LLLT) Platelet-rich Plasma (PRP), Autologous blood injection (ABI), and Prolotherapy Therapeutic Ultrasound Surgery MINOR INTERVENTIONS Botulinum Toxin (Botox) Ergonomics Iontophoresis Manual Therapy / Massage Needling Techniques (Acupuncture, dry needling, etc.) Nitroglycerine/Nitric Oxide/Glyceryl Trinitrate (GTN) Pain Medication Stretching Exercises Supplements Transcutaneous Electrical Nerve Stimulation (TENS) Wait and See (AKA Watchful Waiting) Calcific Tendinopathy Bracing Pain Neuroscience Education Talking Points Intervention Flowchart Appendix: SUMMARY OF TENDINOPATHY REHABILITATION RECOMMENDATIONS Notes Chapter 8 Bibliography