7 ABSOLUTELY CRUCIAL Facts About Tendons

[@charlesbartleson6109]

You guys present the best summary of evidence and effectively bridge that evidence to clinical application. Love your content. It really helps my practice, including my PT students.

[@renaissancewellness9056]

Fantastic video! It was concise and extremely informative!

[@mimilili99]

Wow, what an interesting video summarizing very important information. Thank you very much for sharing!

[@nrjsingh94]

Can u describe how to deal with tendonopathy (jumpers knee in my case ) . When to rest, exercise and restart the full loading. Thanks for your informative video.

If you just got it, expect at least 3 months of rehab. You should avoid immobilizing yourself too much, but neither provoke the pain. Progressively increasing load is the crucial step and you can think about it in 4 parts. 1: this is the acute part of the time line. You should do movements to stimulate circulation, such as flexing and extending your ankle while lying on your back (20-40 reps every hour), and another one is sitting on a chair/lying on the floor extending/flexing your knee while letting your foot glide against the floor. You can also start doing some very light strength exercises: a) lay on floor with a rolled towel under the thigh side of the knee and extend your knee, b) raise your leg from the ground while lying on your back, stomach and sides (both a and b should be done with 10-20 reps 3-5 times a day) and c) shift your weight over to one leg for about 5 seconds, then rest, then shift etc and do this for about 20-40 times. This is a good and safe way to get you started until they make a more complete video on it :-) As I said, these movements are very light and safe to do, but if anything feels uncomfortable or you’re not sure what I mean, don’t do it (English is not my main language)! Also, see a physiotherapist in real life xD Source: I’m a physiotherapy student.

[@nrjsingh94]

@ thanks for your beautiful suggestion. But here is a problem, after getting patellar tendenitis when should i start light exercise/ stretching because in some studies i have read that initial rest is also important. I got your English. English is not also my mother tongue. I speak Hindi (India ) Thanks for your precious time. 😊

@@nrjsingh94 The initial rest is the swelling and acute pain to reside :-) you should be able to do these now. I'm guessing you haven't been bedridden since I wrote my first reply? If you can walk, then the exercises I suggested should be no problem! But I wont comment on the next phases which involve more load because I would have to see your leg to do that!

[@joshuac717]

Fantastic! Thank you!

[@timothyvanpelt_cyclist]

I once had an inflamed tendon to the thumb (De Quervain). It kept hurting for months and conservative treatment didn't help. Once I got a steroid injection it was gone within a day and it never came back (as it was caused by a repetitive movement I normally don't make). Research I did at the time showed injections for this particular type of inflammation were of significant help.

[@Physiotutors]

They can indeed help and especially short-term results are generally favorable

[@alexandrep9852]

best channel ever

[@adolfventer7481]

What is your take on Keith Baar's opinion that the damaged portion of the tendon can indeed be healed by relaxing the healthy part with long isometrics so that the damaged part can sense load and adapt?

[@lucavigano4130]

Great tips, thx guys!

[@dorsanvancutsem1807]

is it possible to subtitles your videos? it would be easier for the beginners in english to understand :-) thanks for the video!

[@Physiotutors]

Subtitling takes a lot of time and googles automatic subtitles are pretty accurate already. If we get some more resources we will take up subtitling again

[@RyleyRehab]

Is there any evidence that strengthening tendons can be preventative vs future tendinopathy?

[@Hellomasteruu]

Great info ♥️bro👌

[@Sweatyenergy876]

What would be an example of #4 for humans? Arch support while running?

[@rubenk8167]

Great!!

[@christoshtz]

Do these facts apply to all tendons? Even in patients with extensor tendinopathy?

[@lifeisoncenottwice4794]

Is your tendon problem cured?

[@christoshtz]

@@lifeisoncenottwice4794 never had one

[@allicarter4248]

This was really interesting. I have struggled with Achilles tendonopathy for 20 years (long distance runner &ironman)- never had an MRI but had physio - there is some palpable scar tissue. In your opinion, should I not bother with the eccentric calf raise protocol? I’d be interested to hear if there are alternatives. Thanks, your videos are always insightful.

[@DanielSmith-iy3il]

So with the eccentric calf raise protocol and the article they reference in the video, what they found was that patients who followed the protocol did have a significant increase in their VISA-A outcome measure which looks at pain, function, and activity level. The study just states that this can't be attributed to an increase in cross sectional area or tendon volume as seen on MRI. The improvement could be related to other changes such as neuromuscular improvements, hypertrophy of the soleus/gastroc, strength/quality of the healthy portion of the tendon, etc. All they can say from the study is that the eccentric protocol doesn't lead to an increase in cross sectional area/volume of the tendon, therefore MRI doesn't provide value in prognosis for this condition. Without doing an exam/getting more info it's hard to make a recommendation but I think there's value in a structured eccentric protocol (to treat the healthy portion of the tendon and the muscle). Depending on the specific case this should probably be in combination with modifications to training schedule/volume, looking at running gait mechanics, and addressing any other muscle weaknesses/imbalances in the chain.

[@allicarter4248]

@@DanielSmith-iy3il Thanks for your clarity Daniel, I guess it'll be better to keep all the surrounding structures strong and put up with the discomfort if it's not likely to rupture. I do need to find the right people to help with my mechanics which must be the reason for such an extended period of problems. Thanks again.

[@jonduke4748]

Start with light mostly eccentric work and get heavier over time. Also in addition perform daily 10 minute sessions with very little weight just to flood the area with blood. Try not to aggravate the tendon and keep making steady-slow progress over several months. Take like 10-15 grams of type 2 collagen and a moderate dosage of vitamin C 30 minutes to an hour before you perform the work, this combination has a fairly substantial impact on the rate of protein/collagen synthesis in the tendon after the work but it's important to take it before doing the work and not just whenever because tendons have very poor blood flow and don't repair/regenerate very much at all without stimulus, this is why tendon issues can last for years. You may never recover fully if you have larger tears in the fine structure of the tendon and much scar tissue, but you can certainly see significant improvement over just a few months to a year. Trust me, I've recovered from tendinopathy in my knee which was a nuisance for over a year and a half. I also used this methodology to cure the nasty tendonitis in both of my wrists caused by working out too hard.

[@Mertt1990]

@@jonduke4748 so are you 100% with your knee? Some people say they are even better some say they never reach the previous strength

[@filipzivkovic4866]

What about Kieth Baars research where they treated a professional basketball player with patellar tendinopathy on MRI with stress relaxation protocols (knee extension, leg press and the spanish squat mid-range iso holds with >80% 1RM) and gelatin supplementation? They managed to get to a point where an MRI showed a normal tendon. I highly doubt it was gelatin that was responsible for that. I'm also aware of the fact that it is a case study, but still, it is preliminary evidence. What do you think about that?

[@TheDirthound]

Then would a job that consisted of daily driving up to 2-3 hrs daily and cycling 1-3times a week as an activity cause gluteal tendinopathy?

[@VasiliadisNikolaos]

Hallo Kai und Andreas, ist es möglich diese neuen Videos dem Kurs obere und untere Extremität einzupflegen? Ich glaube diese würden den Kurs richtig gut ergänzen. VG Niko

[@Physiotutors]

Hi Niko, wir haben das auf der Agenda den Kurs zu updaten wo es Sinn macht. Da wird wahrscheinlich tendinopathy reinkommen und mehr Übungen noch zu diversen Erkrankungen. Wann können wir aber stand heute noch nicht sagen

[@thomasromeni8063]

Hi . Ich bin durch meine Suche nach Erklärungen und Hilfe wegen meiner beidseitig Tendinitis Trochanterica die mich seit 9 Monaten quält auf Eueren Kanal gestoßen . Ich wäre froh so eine Quelle in deutsch zu haben . Es wäre wirklich interessant wenn noch einige Videos zu unterschiedlichen Tendonopathien , in meinem Fall alles was mit den Muskelansätzen am großen Rollhügel zu tun hat , erscheinen würden . Grüße , Thomas .

[@leemin7824]

If like u say no 2, we can't heal a tendon, so will the tendon forever get degenerated and end up with rupture with sudden high loading?

[@jonduke4748]

Degenerative tendinopathy, meaning you've developed holes/rips in the structure of the tendon. Otherwise, the tendon will recover. Furthermore he alludes to the fact that the tissue surrounding the damaged structure seems to become stronger to compensate for the damage. Most degenerative tendinopathy happen to be fairly small tears and so with some time and rehab, the resulting adaptation in the rest of the tendon should be enough so that you don't need to worry much. Most people experience tendonitis which is different but can certainly lead to tendinopathy.

[@haifa0243]

Hey whenever I lay On my back and try to straight up my leg it starts to shake and i get numb, it’s the same symptoms on both legs and they are very weak and I can’t walk for more than 20 minutes. Do you have an idea of what it can be ? Sorry for my bad English :)

[@torvaderon]

You shouldn't get diagnosed online. Just go see the doctor.

[@stephencracknell5077]

I played football up to the age of 28 with no associated foot problems but still ruptured my Achilles..10 yrs later the same happened to the opposite foot and again there was no associated injury..was I just unlucky.

[@daNATEP]

If i understood right, thats normal. You had pathology occurring in the tendons but without pain. When people have the pain, the tendons dont tear, but everytime theres a tear there was already damage that the person didnt know about/feel

[@sajjad3730]

Why all the researchers have et al in the last of their names?

[@TwinGeminiStudio]

"et al" means there are more authors. Depending on your citation source, you only list x number of the primary authors with "et al" denoting others.

[@georgiostyros7092]

Thumbs up guys

[@Matteo82u]

Unfortunately, Jill Cook has forgotten about the hysteresis: a mechanical property of viscoelastic human tissues. Healthy tendon can rupture by itself...

[@johnmarlon6916]

So after 18 months of pain (no tear) I can look forward to at least double that time.

[@lifeisoncenottwice4794]

Is your tendon problem cured?

[@johnmarlon6916]

Sadly now, get injections every 4/8 months.

[@lifeisoncenottwice4794]

@@johnmarlon6916 Sorry to hear that, what kind of injections are these?