Category: Tendinitis/Tendinopathy
-
Pain in the Butt, Sacroiliac Pain as Tendinopathy?
I recently finished the 3rd edition Stuart McGill’s “Low Back Disorders.” I’ve followed his work since reading edition 2 and bulk of my back pain treatments are based on, or consistent with it and his more recent research. For those who don’t know, McGill is a Professor of Spine Biomechanics at the University of Waterloo…
-
Coracoid Pain Test does NOT diagnose Adhesive Capsulitis
Coracoid pain test: a new clinical sign of shoulder adhesive capsulitis.Carbone S, Gumina S, Vestri AR, Postacchini R. Int Orthop. 2010 Mar;34(3):385-8. “Patients with adhesive capsulitis were clinically evaluated to establish whether pain elicited by pressure on the coracoid area may be considered a pathognomonic sign of this condition. The study group included 85 patients…
-
Coracoidopathy Diagnosis Confirmed in New Study
This paper just came out in June this year confirming what I call coracoidopathy (tendinopathy of the short head of the biceps and coracobrachialis muscles where they attach at the coracoid process). They called it “coracoid syndrome,” which I might as well, if they had named it before I did, however I do feel like…
-
Coracoid Impingement Syndrome and Coracoidopathy
This blog is probably only of interest to professionals since coracoid impingement syndrome (CIS) is thought to be a very rare, though important, shoulder pathology. CIS describes when the coracoid process is thought to physically impinge upon the lesser tuberosity of the humerus, pinching the subscapularis tendon and perhaps the long head of the biceps…
-
Bench Press Shoulder Pain, Probably Coracoidopathy
I’ve done my share of bench presses, mostly back in my bodybuilder years before I got involved in Olympic weightlifting. Back then (well before I was a physical therapist) if someone in the gym had shoulder pain with bench press, none of us knew what it was, and almost nobody thought to see a doctor…
-
Coracoidopathy: The Missing Link in Shoulder Pain
To cut to the chase, coracoidopathy (a term I made up) is an unbeknownst but common cause of shoulder pain. My preliminary data gathered from my shoulder pain referrals suggest it is present in up to 85% of people with shoulder pain. It is the primary diagnosis in over a third of them, and is…
-
Hip Pain, Trochanteric “Bursitis”/Tendinopathy, Exercise Best, Cortisone Worst
This study was more interesting in its entirety than its abstract. I thought the home exercises given were beyond banal, but they still turned out best in the long term. Cortisone injected into tendons was yet again shown to be fool’s gold, and shock wave therapy? I don’t know but I’m still skeptical. More comments…
-
High Resistance / Weights Needed for Tendon Adaptation
Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude. Arampatzis A1, Karamanidis K, Albracht K. J Exp Biol. 2007 Aug;210(Pt 15):2743-53. [FREE FULL TEXT] AbstractTendons are able to remodel their mechanical and morphological properties in response to mechanical loading. However, there is little information about the effects of controlled…
-
Tennis Elbow, Strong Evidence AGAINST Platelet-Rich Plasma
Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review. de Vos RJ, Windt J, Weir A. Br J Sports Med. 2014 Jun;48(12):952-6. AbstractBACKGROUND:Chronic lateral epicondylar tendinopathy is frequent in athletes, and platelet-rich plasma (PRP) is being used increasingly in its treatment. OBJECTIVE:To systematically review the literature on the efficacy of PRP…
-
Low Level Laser Doesn’t Work for Tendinitis Either
Clinical effectiveness of low-level laser therapy as an adjunct to eccentric exercise for the treatment of Achilles’ tendinopathy: a randomized controlled trial. Tumilty S, McDonough S, Hurley DA, Baxter GD. From the AbstractOBJECTIVE:To investigate the effectiveness of low-level laser therapy (LLLT) as an adjunct to a program of eccentric exercises for the treatment of Achilles’…
-
Tennis Elbow and Treatment Frequency
Changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis caused by frequency of physical therapy: a randomized controlled trial. Lee S1, Ko Y1, Lee W1. J Physical Therapy Science. 2014 Jul;26(7):1037-40. [Free Full Text] Abstract[Purpose] The purpose of this study was to investigate the changes in pain, dysfunction, and grip strength…
-
Strength Better than Stretch for Plantar Fasciitis
High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2014 Aug 21. Rathleff MS1, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen JL. AbstractThe aim of this study was to investigate the effectiveness of shoe inserts and…
-
Foot Muscle Fatigue Causes Loss of Foot Arch
Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008 Jun;18(3):420-5. Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. AbstractOur purpose was to assess the effect of foot intrinsic muscle fatigue on pronation, as assessed with navicular drop, during static stance. Twenty-one healthy young adults participated. Navicular drop was…
-
Foot Intrinsic Muscles Important for Foot Arch
Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003 Nov-Dec;42(6):327-33. Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Abstract Much of the work describing support of the medial longitudinal arch has focused on the plantar fascia and the extrinsic muscles. There is little research concerning…
-
Plantar Fasciitis Sufferers Have Weaker Foot Muscles
Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Physical Therapy. 2003 Aug;33(8):468-78. Allen RH, Gross MT. Abstract STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine if a difference exists in toe flexors strength and passive extension range of motion of the first…
-
Plantar Fasciitis Associated with Foot Muscle Atrophy
Use of MRI for volume estimation of tibialis posterior and plantar intrinsic foot muscles in healthy and chronic plantar fasciitis limbs. Chang R, Kent-Braun JA, Hamill J. Clin Biomech (Bristol, Avon). 2012 Jun;27(5):500-5. Abstract BACKGROUND: Due to complexity of the plantar intrinsic foot muscles, little is known about their muscle architecture in vivo. Chronic plantar fasciitis…
-
Plantar Fasciitis: Orthotics Don’t Help Much
Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Arch Intern Med. 2006 Jun 26;166(12):1305-10. Landorf KB, Keenan AM, Herbert RD. AbstractBACKGROUND:Plantar fasciitis is one of the most common foot complaints. It is often treated with foot orthoses; however, studies of the effects of orthoses are generally of poor quality, and to our…
-
Tennis Elbow: Both Concentric and Eccentric Exercise Helps
A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy). Clin Rehabil. 2014 Mar 14. [Epub ahead of print] Peterson M, Butler S, Eriksson M, Svärdsudd K. Abstract Objective:To analyse treatment effects of eccentric vs. concentric graded exercise in chronic tennis elbow.Design:Randomized controlled trial.Setting:Primary care in Uppsala County,…
-
Shooter’s Elbow (aka Tennis Elbow / Golfer’s Elbow)
Shooter’s elbow is a bit of a made up term. If it hurts on the outside of your elbow, then it’s the same as tennis elbow (lateral epicondylitis) and if it hurts on the inside of your elbow it’s golfers elbow (medial epicondylitis). I don’t know if any of my friends play tennis, and only…
-
Alfredson’s exercise program in Achilles tendinopathy 5 years later
A 5-year follow-up study of Alfredson’s heel-drop exercise programme in chronic midportion Achilles tendinopathy. van der Plas A, de Jonge S, de Vos RJ, van der Heide HJ, Verhaar JA, Weir A, Tol JL. Br J Sports Med. 2011 Nov 10. [Epub ahead of print] AbstractBACKGROUND: Eccentric exercises have the most evidence in conservative treatment…
-
Tennis Elbow: Improved with Isometric Exercise
Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3. AbstractBACKGROUND: The aim of this prospective randomized clinical trial was to investigate the efficacy of a home-based…
-
Cortisone, Eccentric vs Heavy Slow Resistance for Patellar Tendinopathy
Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Kongsgaard M, Kovanen V, Aagaard P, Doessing S, Hansen P, Laursen AH, Kaldau NC, Kjaer M, Magnusson SP. Scand J Med Sci Sports. 2009 Dec;19(6):790-802. Epub 2009 May 28. Abstract A randomized-controlled single-blind trial was conducted to investigate the clinical, structural…
-
Eccentric vs Eccentric Plus Shock-Wave Treatment for Achilles Tendinopathy
Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial. Rompe JD, Furia J, Maffulli N. Am J Sports Med. 2009 Mar;37(3):463-70. Epub 2008 Dec 15. AbstractBACKGROUND: Results of a previous randomized controlled trial have shown comparable effectiveness of a standardized eccentric loading training and of repetitive low-energy shock-wave…
-
Eccentric Exercise and Heel Brace for Achilles Tendinopathy
Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without the AirHeel Brace. A randomized controlled trial. A: effects on pain and microcirculation. Knobloch K, Schreibmueller L, Longo UG, Vogt PM. Disabil Rehabil. 2008;30(20-22):1685-91. AbstractPURPOSE: To compare eccentric training and the combination of eccentric training with the…
-
Eccentric Exercise vs. Ultrasound for Achilles Tendo Pain
Eccentric calf muscle training compared with therapeutic ultrasound for chronic Achilles tendon pain–a pilot study. Chester R, Costa ML, Shepstone L, Cooper A, Donell ST. Man Ther. 2008 Dec;13(6):484-91. Epub 2007 Jul 26. Abstract A number of studies have indicated that eccentric calf muscle training has beneficial effects in the management of Achilles tendon pain…
-
Eccentric calf muscle training in athletic patients with Achilles tendinopathy
Eccentric calf muscle training in athletic patients with Achilles tendinopathy. Maffulli N, Walley G, Sayana MK, Longo UG, Denaro V. Disabil Rehabil. 2008;30(20-22):1677-84. AbstractPURPOSE: To evaluate the effects of eccentric strengthening exercises (ESE) in athletic patients with Achilles tendinopathy.METHODS: Forty-five athletic patients (29 men, average age 26 years +/- 12.8, range 18 – 42; 16…
-
No Rest Necessary for Achilles Tendinopathy
Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Am J Sports Med. 2007 Jun;35(6):897-906. AbstractBACKGROUND: Achilles tendinopathy is a common overuse injury, especially among athletes involved in activities that include running and jumping. Often an initial period…
-
Anatomic factors related to the cause of tennis elbow
Anatomic factors related to the cause of tennis elbow. Bunata RE, Brown DS, Capelo R. J Bone Joint Surg Am. 2007 Sep;89(9):1955-63. AbstractBACKGROUND: The pathogenesis of lateral epicondylitis remains unclear. Our purpose was to study the anatomy of the lateral aspect of the elbow under static and dynamic conditions in order to identify bone-to-tendon and…
-
Eccentric exercise in treatment of Achilles tendinopathy
Eccentric exercise in treatment of Achilles tendinopathy. Nørregaard J, Larsen CC, Bieler T, Langberg H. Scand J Med Sci Sports. 2007 Apr;17(2):133-8. AbstractAIM: Prognosis and treatment of Achilles tendon pain (achillodynia) has been insufficiently studied. The purpose of the present study was to examine the long-term effect of eccentric exercises compared with stretching exercises on…
-
Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy
Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achilles: a randomized controlled trial. Rompe JD, Nafe B, Furia JP, Maffulli N. Am J Sports Med. 2007 Mar;35(3):374-83. Epub 2007 Jan 23. AbstractBACKGROUND: Few randomized controlled trials compare different methods of management in chronic tendinopathy of the main…
-
Achilles Tendinopathy, Symptom Recovery Does Not Ensure Functional Recovery
Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Br J Sports Med. 2007 Apr;41(4):276-80; discussion 280. Epub 2007 Jan 29. AbstractOBJECTIVE: To assess the relationship between muscle-tendon function and symptoms in patients with Achilles tendinopathy using a validated test…
-
Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy
Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy. Sayana MK, Maffulli N. J Sci Med Sport. 2007 Feb;10(1):52-8. Epub 2006 Jul 7. AbstractOBJECTIVE: Achilles tendinopathy is prevalent in athletes, but can also affect sedentary patients. We studied the effects of eccentric exercises in sedentary non-athletic patients with Achilles tendinopathy.METHODS: Thirty-four sedentary patients (18…
-
Surgical Treatment vs. Eccentric Training for Jumper’s Knee
Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper’s Knee). A randomized, controlled trial. Bahr R, Fossan B, Løken S, Engebretsen L. J Bone Joint Surg Am. 2006 Aug;88(8):1689-98. Abstract BACKGROUND: Although the surgical treatment of patellar tendinopathy (jumper’s knee) is a common procedure, there have been no randomized, controlled trials comparing this treatment…
-
Tennis Elbow: Ice Has Zero Effect
A controlled clinical pilot trial to study the effectiveness of ice as a supplement to the exercise programme for the management of lateral elbow tendinopathy. Manias P, Stasinopoulos D. Br J Sports Med. 2006 Jan;40(1):81-5. AbstractBACKGROUND: The use of ice as a supplement to an exercise programme has been recommended for the management of lateral…
-
Jumper’s Knee, Eccentric Better than Concentric Exercise?
Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomized study. Jonsson P, Alfredson H. Br J Sports Med. 2005;39(11):847-850. AbstractBACKGROUND: A recent study reported promising clinical results using eccentric quadriceps training on a decline board to treat jumper’s knee (patellar tendinosis). METHODS: In this prospective study, athletes…
-
Standard PRE as Good as Eccentric Exercise for Jumper’s Knee in Season Volleyball
No effect of eccentric training on jumper’s knee in volleyball players during the competitive season: a randomized clinical trial. Visnes H, Hoksrud A, Cook J, Bahr R. Clin J Sport Med. 2005 Jul;15(4):227-34. AbstractBACKGROUND: The effect of surgery on patellar tendinopathy (jumper’s knee) is questionable, and conservative treatment protocols have not been properly documented. PURPOSE:…
-
Decline Squats for Volleyball Players with Patellar Tendinopathy
Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H. Br J Sports Med. 2005 Feb;39(2):102-5. Erratum in: Br J Sports Med. 2005 Apr;39(4):246. AbstractBACKGROUND: Conservative treatment of patellar tendinopathy has been minimally investigated.…
-
Eccentric Training and Neovascularisation in Achilles Tendinosis
Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis? Ohberg L, Alfredson H. Knee Surg Sports Traumatol Arthrosc. 2004 Sep;12(5):465-70. Epub 2004 Apr 2. Abstract The background to the good clinical results reported using painful eccentric calf-muscle training as treatment for chronic painful mid-portion Achilles tendinosis is not known.…
-
Eccentric Calf Muscle Training for Achilles Tendinitis
Chronic Achilles tendon pain treated with eccentric calf-muscle training. Fahlström M, Jonsson P, Lorentzon R, Alfredson H. Knee Surg Sports Traumatol Arthrosc. 2003 Sep;11(5):327-33. Epub 2003 Aug 26. Abstract Injuries involving the Achilles tendon and manifested as chronic tendon pain are common, especially among recreational athletes. In a pilot study on a small group of…
-
Decline Squats for Patellar Tendinopathy
A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM. Br J Sports Med. 2004 Aug;38(4):395-7. AbstractOBJECTIVES: This non-randomised pilot study investigated the effect of eccentric quadriceps training on 17 patients (22 tendons) with painful chronic patellar…
-
Drop Squats vs. Leg Extension/ Curl for Jumper’s Knee
A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper’s knee in athletes: pilot study. Cannell LJ, Taunton JE, Clement DB, Smith C, Khan KM. Br J Sports Med. 2001 Feb;35(1):60-4. AbstractOBJECTIVES: To compare the therapeutic effect of two different exercise protocols in athletes with…
-
Eccentric Training for Lateral Epicondylitis
Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia. Svernlov B, Adolfsson L. Scand J Med Sci Sports. Dec 2001;11(6):328-334. Abstract In a pilot study 38 patients with lateral humeral epicondylalgia were randomly allocated to two treatment groups. Group S (stretching) was treated with a contract-relax-stretching program while group E (eccentric exercise) underwent an…
-
Eccentric vs. Concentric Training in Achilles Tendinitis
Superior short-term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis. Mafi N, Lorentzon R, Alfredson H. Knee Surg Sports Traumatol Arthrosc. 2001;9(1):42-47. Abstract In a previous uncontrolled pilot study we demonstrated very good clinical results with eccentric calf muscle training on…
-
Eccentric Overload Training and Chronic Achilles Tendinitis
Eccentric overload training for patients with chronic Achilles tendon pain–a randomised controlled study with reliability testing of the evaluation methods. Silbernagel KG, Thomeé R, Thomeé P, Karlsson J. Scand J Med Sci Sports. 2001 Aug;11(4):197-206. Abstract The purpose was to examine the reliability of measurement techniques and evaluate the effect of a treatment protocol including…
-
Isokinetic Eccentric Exercise for Recurrent Tendinitis
Treatment of recurrent tendinitis by isokinetic eccentric exercise. Croisier J-L, Forthomme B, Foidart-Dessalle M, Godon B, Crielaard J-M. Isokinetics and Exercise Science. 2001;9:133-141. Diagnosis: 9 Achilles, 10 patellar, and 15 lateral epicondyllar Outcome: 15/34 patients had complete relief of symptoms, 10/34 had marked decrease in symptoms, 5/34 had moderate decrease in symptoms, and 4/34 had…
-
Heavy Load Eccentric Training for Achilles Tendinosis
Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Alfredson H, Pietila T, Jonsson P, R. L. Am J Sports Med. 1998;26(3):360-366. Abstract We prospectively studied the effect of heavy-load eccentric calf muscle training in 15 recreational athletes (12 men and 3 women; mean age, 44.3 +/- 7.0 years) who had the…
-
Evaluation of Eccentric Exercise in Treatment of Patellar Tendinitis
Evaluation of eccentric exercise in treatment of patellar tendinitis. Jensen K, Di Fabio RP. Physical Therapy. 1989 Mar;69(3):211-6. Abstract The purpose of this study was to analyze the effects of a quadriceps femoris muscle eccentric training program on strength gain in patients with patellar tendinitis. The effect of an eight-week eccentric exercise program on quadriceps…
-
Original Eccentric Exercise/Tendinitis Study
Eccentric exercise in chronic tendinitis.Stanish WD, Rubinovich RM, Curwin S. Clin Orthop Relat Res. 1986 Jul;(208):65-8. AbstractChronic tendinitis, particularly of the Achilles tendon, frequently outwits traditional programs of therapy including surgery and/or prolonged immobilization. A hypothesis proposes that disruption of the tendon, micro or macro, occurs under specific conditions of eccentric loading. In order for…