Physio Edge podcast with David Pope
138. How to treat patellar & achilles tendinopathy with Daniel Silvan
Episode guests
Podcast summary created with Snipd AI
Quick takeaways
- Educate patients on delayed pain response and monitor symptoms for long-term improvements in tendinopathy treatment.
- Assess tendon stresses and start exercises that isolate the tendon effectively, using tests like single leg extensions for guidance.
- Use a progression of tests like single-leg extensions, hopping, and squat jumps to gauge pain levels and functional abilities in athletes with tendinopathy.
- Tailor exercise programs based on individual assessments and adapt exercises to the athlete's abilities for optimized outcomes in tendon rehabilitation.
Deep dives
Educating Patients About Pain in Tendonopathy
Educating patients about pain in tendonopathy is a crucial aspect of initial sessions. Explaining the delayed pain response, how to monitor pain, and its behavior over time are key points. Teaching them to focus not just on immediate pain during exercises but on how they feel the next day or later helps shift their perspective from short-term to long-term improvements.
Identifying the Right Level of Exercises for Patients
Identifying the appropriate level of exercise for tendinopathy patients involves assessing specific tendon stresses. Exercises that maximize load in a lengthened position isolate the tendon effectively. Tests such as single leg extensions or Spanish squats can help gauge the initial level of exercise. Monitoring muscle responses and adaptations during manual muscle tests also guides the selection of starting exercises.
Testing for Pain Levels and Adaptation in Athletes
In assessing pain levels and adaptation in athletes with tendinopathy, starting with a simple progression of tests can provide valuable insights. Testing for shaking during resisted single-leg extensions and assessing hopping and squat jumps, both two-legged and single-legged, can help determine pain levels and functional abilities. This rapid progression of tests helps gauge pain response and functional limitations.
Progressing Exercise Levels Based on Test Results
Progressing exercise levels based on test outcomes involves tailoring the regimen to the individual. Combining isometric, concentric, and eccentric exercises with plyometric activities like jumps and hops ensures a comprehensive approach. The patient's response to manual tests and functional activities guides the adjustment of exercise intensity and specificity, allowing for targeted and effective treatment.
Streamlining Initial Assessments and Progressions for Athletes
Streamlining initial assessments and progressions for athletes with tendinopathy involves a systematic approach to testing and adaptation monitoring. By combining manual muscle tests, functional movements, and plyometric assessments, clinicians can efficiently determine starting exercise levels and progression paths tailored to individual needs. This structured approach optimizes treatment interventions for better outcomes.
Customizing Exercise Programs Based on Functional Profiles
Tailoring exercise programs for athletes with tendinopathy according to their functional profiles ensures targeted and effective interventions. Understanding individual responses to muscle tests, jumping exercises, and manual assessments helps in customizing exercise regimens. By adapting the treatment plan to the athlete's abilities and limitations, clinicians can optimize rehabilitation strategies for improved outcomes.
Assessment Importance for Tailoring Exercise Programs
Tailoring exercise programs based on individual assessments is crucial for addressing specific needs. By conducting a quick one-minute assessment, practitioners can identify strength, kinetic chain, and plyometric training priorities. For instance, assessing pain responses in single leg hops can guide the selection of the Spanish squat or seated calf raise for Achilles tendon issues. Prioritizing load magnitude over exercise type enables effective tendon loading in a time-efficient manner.
Progressive Loading Strategies for Tendon Rehabilitation
In tendon rehabilitation, progressive loading strategies play a vital role in optimizing outcomes. Customizing exercises based on the individual's response and focusing on quality over quantity are key principles. By gradually increasing load intensity, duration, or repetitions, practitioners can ensure effective tendon stimulation. Balancing total load magnitude with exercise specificity and adaptation monitoring is essential for successful and tailored rehabilitation programs.
How can you treat patients with an achilles or patellar tendinopathy while they’re in the middle of a season or training for an event? Successful treatment often includes loading and strengthening the tendon, but how can you quickly identify the best exercises and load for each patient?
Find out in this Physio Edge podcast as David Pope and Daniel Silvan (Head Physiotherapist at Aspire Academy, Aspetar) discuss how to choose the most effective exercises for your patients to successfully treat lower limb tendinopathy.
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