This week, I had an engaging conversation with Anthony Nasser, an up-and-coming researcher on tendinopathy who recently completed his PhD on proximal hamstring tendinopathy. Our discussion covered the reasons for the lack of research attention towards this condition, the current state of evidence, and insights from his doctoral studies. You can find the full conversation here.

Here are Anthony's related publications:

Nasser, A.M., Pizzari, T., Grimaldi, A., Vicenzino, B., Rio, E. and Semciw, A.I., 2021. Proximal hamstring tendinopathy; expert physiotherapists’ perspectives on diagnosis, management and prevention. Physical Therapy in Sport, 48, pp.67-75.


Nasser, A.M., Vicenzino, B., Grimaldi, A., Anderson, J. and Semciw, A.I., 2021. Proximal hamstring tendinopathy: a systematic review of interventions. International journal of sports physical therapy, 16(2), p.288.


Nasser, A., Semciw, A., Grimaldi, A., Rio, E., Pizzari, T. and Vicenzino, B., 2022. Core outcome set development for proximal hamstring tendinopathy (COS-PHT): a study protocol. Physical Therapy Reviews, 27(4), pp.313-319.

This week, I had an engaging conversation with <a href="https://twitter.com/TonyNasserPT">Anthony Nasser</a>, an up-and-coming researcher on tendinopathy who recently completed his PhD on proximal hamstring tendinopathy. Our discussion covered the reasons for the lack of research attention towards this condition, the current state of evidence, and insights from his doctoral studies. You can find the full conversation here. Here are Anthony's related publications:
<a href="https://pubmed.ncbi.nlm.nih.gov/33378733/">Nasser, A.M., Pizzari, T., Grimaldi, A., Vicenzino, B., Rio, E. and Semciw, A.I., 2021. Proximal hamstring tendinopathy; expert physiotherapists’ perspectives on diagnosis, management and prevention. Physical Therapy in Sport, 48, pp.67-75.</a>
 <a href="https://pubmed.ncbi.nlm.nih.gov/33842025/">Nasser, A.M., Vicenzino, B., Grimaldi, A., Anderson, J. and Semciw, A.I., 2021. Proximal hamstring tendinopathy: a systematic review of interventions. International journal of sports physical therapy, 16(2), p.288.</a>
 <a href="https://www.researchgate.net/publication/360743382_Core_outcome_set_development_for_proximal_hamstring_tendinopathy_COS-PHT_a_study_protocol">Nasser, A., Semciw, A., Grimaldi, A., Rio, E., Pizzari, T. and Vicenzino, B., 2022. Core outcome set development for proximal hamstring tendinopathy (COS-PHT): a study protocol. Physical Therapy Reviews, 27(4), pp.313-319.</a>

This podcast will delve deep into the best and most clinically relevant new studies on tendinopathy. The focus is what questions the researchers tried to answer and why, how they did it, what they found, and very importantly, the so what factor. That is, how can it be applied to the clinic and to individual tendinopathy patients.

Talking Tendons

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These are just a few examples of the many great podcasts available on the Auscast Wellbeing channel. With a variety of hosts and topics, there's something for everyone on this channel. Whether you're looking for expert advice on managing mental health, exploring personal growth, or seeking tips for better sleep, the Auscast Wellbeing channel is the perfect place to start.

The Auscast Wellbeing channel is a collection of podcasts that focus on promoting mental and physical well-being. The channel features a variety of shows that cover a range of topics, including mental health, personal growth, and self-care.
One of the most popular podcasts on the channel is "The Mental Health Show" with Mark Aiston. Mark, a mental health avocate, he interviews experts and provides advice and insights on a wide range of mental health issues, and shares his practical tips for managing stress and improving overall well-being.
For those looking to explore personal growth and self-discovery, "Psychosynthesis with Janine Barelds" is an excellent choice. The host, Janine, a psychotherapist, shares her knowledge of psychosynthesis and guides listeners through the process of self-discovery and personal growth.
Another important topic that this channel covers is sleep. "Sleep Better - Tools to Help You Sleep" is a must-listen for anyone struggling with insomnia or other sleep disorders. The host provides practical tips and advice on how to improve sleep quality and overcome insomnia.
These are just a few examples of the many great podcasts available on the Auscast Wellbeing channel. With a variety of hosts and topics, there's something for everyone on this channel. Whether you're looking for expert advice on managing mental health, exploring personal growth, or seeking tips for better sleep, the Auscast Wellbeing channel is the perfect place to start.

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Auscast Medical Channel is a podcast channel that provides a wide range of medical-related content. The podcasts feature interviews with experts in various medical fields, including doctors, nurses, and other healthcare professionals, as well as discussions on the latest medical research and treatment options. The channel covers a wide range of topics, including general health, mental health, and specific medical conditions. The podcasts are aimed at both healthcare professionals and the general public, and provide listeners with the latest information and insights on healthcare topics. Auscast Medical Channel is a great resource for staying informed about medical issues and trends, and for learning more about how to care for yourself and your loved ones.

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Proximal Hamstring Tendinopathy - the forgotten tendinopathy

This week I talk about a feasibility cohort study which sought to determine whether a larger cohort study addressing this question would be feasible. Listen to hear some interesting preliminary findings. 


Merza, E.Y., Pearson, S.J., Mallows, A.J. and Malliaras, P., 2023. The relationship between psychological, cognitive, and contextual factors and rehabilitation outcomes in Achilles tendinopathy: A prospective feasibility cohort study. Physical Therapy in Sport.

Mallows, A., Jackson, J., Littlewood, C. and Debenham, J., 2020. The association of working alliance, outcome expectation, adherence and self‐efficacy with clinical outcomes for Achilles tendinopathy: A feasibility cohort study (the MAP study). Musculoskeletal Care, 18(2), pp.169-176.

This week I talk about a feasibility cohort study which sought to determine whether a larger cohort study addressing this question would be feasible. Listen to hear some interesting preliminary findings. 
 <a href="https://pubmed.ncbi.nlm.nih.gov/36796168/">Merza, E.Y., Pearson, S.J., Mallows, A.J. and Malliaras, P., 2023. The relationship between psychological, cognitive, and contextual factors and rehabilitation outcomes in Achilles tendinopathy: A prospective feasibility cohort study. Physical Therapy in Sport.</a> <a href="https://pubmed.ncbi.nlm.nih.gov/31997555/">Mallows, A., Jackson, J., Littlewood, C. and Debenham, J., 2020. The association of working alliance, outcome expectation, adherence and self‐efficacy with clinical outcomes for Achilles tendinopathy: A feasibility cohort study (the MAP study). Musculoskeletal Care, 18(2), pp.169-176.</a>

Do psychological, cognitive, and contextual factors influence rehab outcomes in Achilles tendinopathy?

We have known for a while that type of exercise intervention (e.g. intensity, frequency, etc) does not seem to influence self-reported outcomes such as pain. Maybe all the benefits from exercise are explained by non-specific effects, or maybe exercise has benefits that do not depend on the type of exercise.

In this episode, I discuss 3 studies that look into (at least partly) other benefits that we may see at the level of the muscle and tendon from higher-load exercise interventions. 


References:

Radovanović, G., Kunz, J., Bohm, S., Arampatzis, A. and Legerlotz, K., 2021. Reliable and effective novel home-based training set-up for application of an evidence-based high-loading stimulus to improve triceps surae function. Journal of Sports Sciences, 39(24), pp.2786-2795.


Radovanović, G., Bohm, S., Peper, K.K., Arampatzis, A. and Legerlotz, K., 2022. Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial. Sports Medicine-Open, 8(1), pp.1-19.


Radovanović, G., Bohm, S., Arampatzis, A. and Legerlotz, K., 2023. In Achilles Tendinopathy the Symptomatic Tendon Differs from the Asymptomatic Tendon While Exercise Therapy Has Little Effect on Asymmetries—An Ancillary Analysis of Data from a Controlled Clinical Trial. Journal of Clinical Medicine, 12(3),

We have known for a while that type of exercise intervention (e.g. intensity, frequency, etc) does not seem to influence self-reported outcomes such as pain. Maybe all the benefits from exercise are explained by non-specific effects, or maybe exercise has benefits that do not depend on the type of exercise.
In this episode, I discuss 3 studies that look into (at least partly) other benefits that we may see at the level of the muscle and tendon from higher-load exercise interventions. 
 References:
<a href="https://www.tandfonline.com/doi/full/10.1080/02640414.2021.1959981">Radovanović, G., Kunz, J., Bohm, S., Arampatzis, A. and Legerlotz, K., 2021. Reliable and effective novel home-based training set-up for application of an evidence-based high-loading stimulus to improve triceps surae function. Journal of Sports Sciences, 39(24), pp.2786-2795.</a>
 <a href="https://pubmed.ncbi.nlm.nih.gov/36538166/">Radovanović, G., Bohm, S., Peper, K.K., Arampatzis, A. and Legerlotz, K., 2022. Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial. Sports Medicine-Open, 8(1), pp.1-19.</a>
 <a href="https://pubmed.ncbi.nlm.nih.gov/36769750/">Radovanović, G., Bohm, S., Arampatzis, A. and Legerlotz, K., 2023. In Achilles Tendinopathy the Symptomatic Tendon Differs from the Asymptomatic Tendon While Exercise Therapy Has Little Effect on Asymmetries—An Ancillary Analysis of Data from a Controlled Clinical Trial. Journal of Clinical Medicine, 12(3),</a>

Does high load and high strain exercise have any benefit for Achilles tendinopathy?

Palpation can be useful for the diagnosis and assessment of tendinopathy, but there are limits. This is because non-painful tendons can be tender, and tenderness in painful tendons seems to be very slow to get better. 

Link to Evidence for Improvement in Local but not Diffuse Pressure Pain Thresholds Following Physical Therapist Interventions for Tendinopathy: A Systematic Review

Link to  Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players

Palpation can be useful for the diagnosis and assessment of tendinopathy, but there are limits. This is because non-painful tendons can be tender, and tenderness in painful tendons seems to be very slow to get better. 
Link to <a href="https://academic.oup.com/ptj/advance-article-abstract/doi/10.1093/ptj/pzac159/6825273?redirectedFrom=fulltext">Evidence for Improvement in Local but not Diffuse Pressure Pain Thresholds Following Physical Therapist Interventions for Tendinopathy: A Systematic Review</a>
Link to  <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1724272/">Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players</a>

Proximal Hamstring Tendinopathy - the forgotten tendinopathy

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