Fresh off teaching this past weekend at University of Michigan – a great group of folks joind together for a course called “Putting the Athlete Back in Triathlete: a clinician’s role in care of the endurance athlete.” …….and more content to come.
I’ve been invited to be a part of Therapedia’s webcast series, and its airing Thursday this week. And yes, it will be available to view after the course as well. Check out this link for what looks to be an interesting discussion!
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Jay, I would appreciate your comments on the differences between your book and Bruce Wilk’s. The webcast unfortunately had technical difficulties and we were only able to view the first 17 minutes. Thanks.
Am reading your book and wonder why you say the tendons don’t get inflamed and therefore shouldn’t and can’t fall in the classification of an -itis? What reference supports this? Thanks.
I’ve got references in the back of the book to support this statement. If you’d like more, check out this summary paper:
Click to access OveruseTendinosis-PhysSptsmed.pdf
as well as the 35 references mentioned in this paper. Not trying to be smug, but just trying to spread the real truth about tendon issues. Understanding what these issues are about is essential to PROPERLY treating them. Tendonitis doesn’t exist (and yes, its possible to have some ‘pseudo-tendonitis’ in the paratenon, but that’s really the synovial fluid inside the tendon sheath and still not the tendon itself) Best and thanks for reading!
While I appreciate your intention of wanting to highlight the pervasiveness of tendinosis that gets passed off as tendinitis, the reference you gave clearly does not refute the existence of tendinitis but merely downplays its prevalence. Page 3 of your reference states, “Tendinitis is a rather rare condition but may occur occasionally in the Achilles tendon in conjunction with a primary tendinosis.” So I am left back where I began, looking for substantiation of the claim that tendinitis doesn’t exist.
The book is an easy read and should advance people’s understanding of running from many dimensions. Thanks for writing it.
I do understad your point. I’ll approach things from this side. The chemical cascade known as the inflammatory process requires Substance P to initiate this process. I cannot find a single resource showing that substance P exists inside tendon. ……no substance, no inflammation…..thus no tendonitis. As I stated in my previous comment, the small amount of synovial fluid that exists inside the paratenon is capable of swelling. Technically, its inside the sheath surrounding the tendon. So I hope that this doens’t come down to semantics of what’s integral to the tendon itself vs the tendon and its sheath.
Additionally, I’ll be the first one to say that bursal irritation located in close proximity to the tendon itself can overwhelming complicate management. However, this bursal irritation is best relieved through decreasing friction and shear across the point (and yes, minimizing inflammation), rather than aiming to improve strain distribution throughout the tendon itself (which is more the goal of tendinosis management).
Good discussion – thanks for sharing!