By: Brett Windsor, PT

The subject of tendinopathy has been at the forefront of the physical therapy profession for many years now. In recent times, the body of knowledge has largely moved away from the idea that inflammation plays any real role in the pathogenesis and propagation of tendinopathy, towards a more mechanistic explanation that at its core, implies degeneration absent inflammation. The significance of this lies in the approach to treatment – aggressive, mechanistic and stimulatory treatments have become favored. For example – Graston, ASTYM, and cross friction massage have all thrived as PT has come around to the belief that tendinopathy is largely ‘solved’ by using hands or tools to aggressively work tissue – breaking down free nerve endings and small blood vessels that grow into the tissue, in addition to stimulating fibroblasts to lay down new collagen tissue that can then be optimized through targeted neuromuscular rehabilitation techniques.

Well…it may be time to rethink this. Just published in the British Journal of Sports Medicine, Jonathan Rees and colleagues offer a persuasive argument that perhaps we’ve gone a little too far in eliminating inflammation from the tendinopathy equation. It’s a great read and you can enjoy the free full-text discourse by clicking on the link below:

http://bjsm.bmj.com/content/early/2013/03/08/bjsports-2012-091957.full

Enjoy the read!! In our next post, we’ll ‘break it down’ for you.

Best regards. Brett