Overuse tendinosis, not tendinitis, part 1: a new paradigm for a difficult clinical problem (part 1)
PainSci summary of Khan 2000?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible.
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.
related content
- “Overuse tendinosis, not tendinitis, part 2: applying the new approach to patellar tendinopathy,” J L Cook, K M Khan, N Maffulli, and C Purdam, Phys Sportsmed, 2000.
- “Histopathology of common tendinopathies. Update and implications for clinical management,” K M Khan, J L Cook, F Bonar, P Harcourt, and M Astrom, Sports Medicine, 1999.
- “Plantar fasciitis: a degenerative process (fasciosis) without inflammation,” Harvey Lemont, Krista M Ammirati, and Nsima Usen, Journal of the American Podiatric Medical Association, 2003.
- “Treatment of tendinopathy: what works, what does not, and what is on the horizon,” Brett M Andres and George A C Murrell, Clinical Orthopaedics & Related Research, 2008.
These nine articles on PainScience.com cite Khan 2000 as a source:
- Deep Friction Massage Therapy for Tendinitis — A guide to a simple self-massage technique sometimes helpful in treating common tendinitis injuries like tennis elbow or Achilles tendinitis
- Icing for Injuries, Tendinitis, and Inflammation — Become a cryotherapy master
- Save Yourself from IT Band Syndrome! — All your treatment options for Iliotibial Band Syndrome reviewed in great detail, with clear explanations of recent scientific research supporting every key point
- Save Yourself from Patellofemoral Pain Syndrome! — Patellofemoral pain syndrome (aka runner’s knee) explained and discussed in great detail, including every imaginable self-treatment option and all the available scientific evidence
- Save Yourself from Plantar Fasciitis! — Plantar fasciitis explained in great detail, including every possible treatment option, and all supported by recent scientific research
- Save Yourself from Tennis Elbow! — Not just for tennis players, straight-talking advice on healing from this common tendinitis (lateral epicondylitis)
- Does Arnica Gel Work for Pain? — A detailed review of popular homeopathic (diluted) herbal creams and gels like Traumeel, used for muscle pain, joint pain, sports injuries, bruising, and post-surgical inflammation
- Pseudo-Quackery in the Treatment of Pain — The large, dangerous gray zone between evidence-based care and overt quackery in musculoskeletal and pain medicine
- Repetitive Strain Injuries Tutorial — Five surprising and important facts about repetitive strain injuries like carpal tunnel syndrome, tendinitis, or iliotibial band syndrome
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.