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Overuse tendinosis, not tendinitis, part 1: a new paradigm for a difficult clinical problem (part 1)

updated

Tags: etiology, treatment, diagnosis, plantar fasciitis, biomechanics, tendinosis, foot, pro, leg, limbs, pain problems, overuse injury, injury

Nine articles on PainSci cite Khan 2000: (1) Deep Friction Massage Therapy for Tendinitis(2) Icing for Injuries, Tendinitis, and Inflammation(3) The Complete Guide to IT Band Syndrome(4) The Complete Guide to Patellofemoral Pain Syndrome(5) Complete Guide to Plantar Fasciitis(6) Save Yourself from Tennis Elbow!(7) Does Arnica Gel Work for Pain?(8) Pseudo-Quackery in the Treatment of Pain(9) Repetitive Strain Injuries Tutorial

PainSci notes on Khan 2000:

From the abstract: “If physicians acknowledge that overuse tendinopathies are due to tendinosis, as distinct from tendinitis, they must modify patient management … ”

original abstract Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

Overuse tendinopathies are common in primary care. Numerous investigators worldwide have shown that the pathology underlying these conditions is tendinosis or collagen degeneration. This applies equally in the Achilles, patellar, medial and lateral elbow, and rotator cuff tendons. If physicians acknowledge that overuse tendinopathies are due to tendinosis, as distinct from tendinitis, they must modify patient management in at least eight areas. These include adaptation of advice given when counseling, interaction with the physical therapist and athletic trainer, interpretation of imaging, choice of conservative management, and consideration of whether surgery is an option.

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