Dear all,

Please find a list of recent tendinopathy research abstracts organised into categories. As it is the first tendinopathy research update, it is my pick of tendinopathy research over the last few months. Future updates will be shorter and only include NEW research over the last month.

Here are some highlights:

Bokhari & Murrell discuss the theoretical basis for the use of nitric oxide (GTN patches) in tendinopathy and success in previous clinical RCT’s whereas Steunebrink et al. found no benefit above eccentric in patellar tendinopathy. This is the second recent study to challenge the original good results of GTN patches.

de Groot found that ‘normal’ rather than pronated foot posture was associated with patellar tendinopathy. This suggests that coronal plane biomechanical issues often associated with flat feet (e.g. internal tibial rotation) is not clearly linked with patellar tendinopathy

Cook and Purdam argue that Compressive load is bad for tendons – compelling review that explains compression in clinical terms. Stop sitting on your ischial tuberosities!

Wang et al show that jumping performance is massively reduced in Achilles tendinosis. This is why progressive stretch-shortening cycle rehabilitation is so important

Hirschmüller suggest Doppler predicts future pain whereas Boesen et al and de Vos et al. found no association with pain. This may be explained by machine sensitivity, Doppler settings, technique, etc

Management reviews have been published for Achilles, patellar and Elbow tendinopathy. Kearney et alLarsson et al, Rowe et al, Taylor et al. The Rowe study is novel in that it includes a systematic review and clinical reasoning from interviews of experienced clinicians

5 years post Achilles Alfredson eccentric training symptoms remain better but pathology is unchanged, van der Plaas et al.

Get them stronger fast and educate to avoid fear avoidance after Achilles repair – makes sense, Olssen et al.

Shockwave therapy, laser therapy and acupuncture are potential adjuncts in treating tendinopathy – Sussmilch-Leitch et al and Neal et al. The critical part is when to apply them. This depends on your beliefs regarding pathology and how these interventions work. For example, if assumed to be a stimulatory therapy, shockwave should be avoided in reactive tendinopathy.

Blood-based or PRP injections dominate tendinopathy injection research but mainly case series (Deans et al, Gosens et al. and Ferrero et al.) – we need RCT’s! The issue of staging is also critical with PRP – I have not included in the blog the several animal models that are regularly published showing that PRP injections are pro-inflammatory, so best to be avoided in reactive tendinopathy or with acute/angry symptoms (I will blog about this separately at some stage).

And plenty more abstracts so have a read…

Here is a link: tendinopathy research blog17_10_12

Hope you enjoy

Peter