UNIT 2: Week 4 Content
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What is some of the subjective data seen with tendinopathy
-recent change in activity or load (frequency, intensity, time, type) -localized pain (can point to it with 1 finger) -pain may initially decrease during activity -pain proportional to load -increased pain in the morning after activity (latent symptoms)
What is a functional loading test you can use for achilles tendon
-heel raise/hopping
What is a functional loading test you can use for a patellar tendon
-single leg squat/jumping
What is a functional loading test you can use for a gluteal tendon
-single leg stance
Where would pain be located in achilles functional loading test
-localized to mid portion of achilles tendon/insertion at calcaneus
Where would pain be located in patellar functional loading test
-localized to mid portion patellar tendon/inferior pole of patella
Where would pain be located in gluteal functional loading test
-localized to mid portion gluteal tendon
Principles of tendon rehabilitation
-relative rest -early mobilization -early strengthening
What is tendinopathy considered to be
-a continuum
What is the old recommendation for tendon loading programs
-eccentrics
What is the assumption about eccentrics for tendon loading in regard to collagen
-load will reorganize collagen fibres
What is the assumption about what the intensity should be for eccentric tendon loading
-non-disabling pain
Does eccentric loading actually reorganize collagen
-not necessarily -eccentrics do not work the way we necessarily thought they did
How much time does tendon structure need to change
-much more time that originally thought -12+ weeks
What did the Silbernagel study reveal about isotonic training for tendon loading
-there was no significant change in group that rested vs group that did pain provoking activity
How does the Silbernagel study apply to athletic populations
-shows that athletic populations do not have to full rest to see recovery -they can do some activity within pain scale and still heal properly
What number on the pain scale (NRPS) can be reached during an activity
-5
What number on the pain scale (NRPS) can be reached after completing an activity
-5
What number on the pain scale (NRPS) can be reached the morning after activity
-5
Is pain allowed to increase (according to the NRPS) from week to week
-no
What types of isotonics should be done in achilles rehab week 1-2
-inner range exercises -(1 or 2 legged heel raise from the floor)
How often should isotonics be done in achilles rehab week 1-2
-3x10 once a day
What types of isotonics should be done in achilles rehab week 2-5
-outer range -(1 or 2 legged heel raise standing on step)
How often should isotonics be done in achilles rehab week 2-5
-3x15 once a day