Eric,

Firstly, I am happy to hear that you are feeling better! You gave us all quite a scare and we missed you at the last course weekend.

Secondly, thank you SO much for this post. I think this was very helpful for me, as tendinopathy is something I find myself struggling to adapt to with each different patient presentation. In the “field of grey” this provides some nice firmer “do’s” and “don’t”s that I think will be helpful for me moving forward with my prescription of exercises and manual therapy with patients in the future.

Thanks again!!

Hey y’all,

I think this is a really good resource that puts a lot of pertinent information in a form that is easy to digest. In clinical practice, I think the second rule, Don’t prescribe incorrect exercise, can be tougher to follow than it may seem. I occasionally find it difficult to determine whether or not an exercise is more than the tendon can handle until I’ve actually tried it.

For example, I have been treating a gentleman for 2-3 months who presented with a reactive on degenerative Achilles tendon that has been bugging him for the past few years who is looking to return to running. We have been progressing slowly, starting with isometrics and eventually progressing to plyometrics and running in the Alter G. Along the way, we have hit periods where the pt is tolerating a certain load and he appears to be ready to progress, but when we progress, he has a big increase in tendon pain for the next 2-3 days. When we tempered expectations and started incorporating those new loads (plyos, for example) more slowly, he was able to tolerate the intervention without issue. I think this graded exposure to loading is something that I tend to rush in these patients due to my own impatience.