Overuse tendinosis, not tendinitis, part 1: a new paradigm for a difficult clinical problem (part 1)
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.
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.
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:
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.
- Association Between Plantar Fasciitis and Isolated Gastrocnemius Tightness. Nakale 2018 Foot Ankle Int.
- No Added Benefit of Combining Dry Needling With Guideline-Based Physical Therapy When Managing Chronic Neck Pain: A Randomized Controlled Trial. Stieven 2020 J Orthop Sports Phys Ther.
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.