Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
Tendinopathy
Dr. Richard Collins
Sport & Musculoskeletal Physician
Bedfordshire MSK
Talk overview
1. Tendinopathy cause
2. Core principles of evidence based treatment
3. Place of adjunct treatment
1. Tendinopathy cause
Musculotendinous Overload
Main functions
• Joint movement
• Primary movers
• Joint stabilisation
• Platform on which the primary movers can work
• E...
Achilles & Patellar Tendon
Functional Overload
Functional Overload
Structural degradation
Warning!
Structural changes are often a normal part of
ageing
Not necessarily associated with symptoms
Interpret imaging c...
Symptoms
• Pain (especially on activating normal function)
• Swelling
Loss of function
2. Treatment Principles?
Restore Capacity!
What will do this?
• Accupuncture?
• Massage?
• Supporting mechanics?
• Muscle strengthening?
‘Physio’
As insightful as th...
•Supporting mechanics
•Muscle strengthening
Physio ✅
How long does it take?
•At least 12 weeks (c.f stress fracture)
•Are you doing them?! (taking their drugs)
•Are you doing ...
Approaches
•Lower Limb Long Tendons?
•Rotator Cuff?
•Tennis Elbow?
3. Adjuncts
Only if struggling with rehab
= Pain
Options?
• Oral/Topical Analgesia?
• Safe to tendons
• Side-effects?
• Steroid Injections?
• Analgesics
• Weaken tendon co...
Talk take home
1. Tendinopathy cause
Functional Overload
2. Core principles of evidence based treatment
Restore capacity t...
Questions?
Tendinopathy Overview
Tendinopathy Overview
Tendinopathy Overview
Tendinopathy Overview
Tendinopathy Overview
Upcoming SlideShare
Loading in …5
×

Tendinopathy Overview

880 views

Published on

Talk prepared for Circle Bedfordshire MSK GP Education Event on Wednesday 22nd Match 2017

Published in: Healthcare
  • Be the first to comment

Tendinopathy Overview

  1. 1. Tendinopathy Dr. Richard Collins Sport & Musculoskeletal Physician Bedfordshire MSK
  2. 2. Talk overview 1. Tendinopathy cause 2. Core principles of evidence based treatment 3. Place of adjunct treatment
  3. 3. 1. Tendinopathy cause Musculotendinous Overload
  4. 4. Main functions • Joint movement • Primary movers • Joint stabilisation • Platform on which the primary movers can work • Energy absorption, storage & release • Long, lower limb tendons • Part of propulsion mechanics
  5. 5. Achilles & Patellar Tendon
  6. 6. Functional Overload
  7. 7. Functional Overload Structural degradation
  8. 8. Warning! Structural changes are often a normal part of ageing Not necessarily associated with symptoms Interpret imaging carefully
  9. 9. Symptoms • Pain (especially on activating normal function) • Swelling Loss of function
  10. 10. 2. Treatment Principles? Restore Capacity!
  11. 11. What will do this? • Accupuncture? • Massage? • Supporting mechanics? • Muscle strengthening? ‘Physio’ As insightful as the word ‘Drugs’
  12. 12. •Supporting mechanics •Muscle strengthening Physio ✅
  13. 13. How long does it take? •At least 12 weeks (c.f stress fracture) •Are you doing them?! (taking their drugs) •Are you doing them in a graded, increased way?
  14. 14. Approaches •Lower Limb Long Tendons? •Rotator Cuff? •Tennis Elbow?
  15. 15. 3. Adjuncts Only if struggling with rehab = Pain
  16. 16. Options? • Oral/Topical Analgesia? • Safe to tendons • Side-effects? • Steroid Injections? • Analgesics • Weaken tendon collagen • Autologous Blood/Platelet Rich Plasma? • Safe to tendons • What are they adding? • Shockwave Therapy • Analgesic • Safe to tendons in skilled hands
  17. 17. Talk take home 1. Tendinopathy cause Functional Overload 2. Core principles of evidence based treatment Restore capacity through supporting function and strengthening muscle 3. Place of adjunct treatment Shockwave Therapy represents the best evidenced and safest approach – but only if appropriate rehab is failing
  18. 18. Questions?

×