The causes of tendinopathy are complex and not fully understood but the results – ranging from mild pain and swelling to complete loss of function – and the frustratingly slow recovery can be devastating, particularly for an athlete. The current consensus is that the best treatment is a careful programme of strengthening and load management. This article clearly describes how to tailor a rehab programme to your patient’s precise needs, and, importantly, what not to do.
This content consists of a 11 minute video presentation professionally produced and presented at the Fisic Conference 2015.
This content consists of a 12 minute video presentation professionally produced and presented at the Fisic Conference 2015.
This content consists of a 13 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Professor Håkan Alfredson is a world renowned Tendon Specialist and Orthopaedic Consultant from Sweden, specialising in the Achilles, Patella & Elbow tendons. He is a professor of sports medicine and an orthopaedic surgeon, with a PhD in bone mass. He received his PhD in Sports Medicine from Umea University in 1997, receiving an Associate Professorship in Orthopaedic Surgery and Sports Medicine in 1999, and a full Professorship in Sports Medicine in 2002.
Professor Alfredson is one of the world's leading consultants in tendons. He runs a Clinic in London at Pure Sports Medicine and has a practice in Umea, Sweden. He has been Doctor for the Swedish National Junior Ice Hockey Team, and was Physician for (Farjestad BK) in Sweden.
Professor Alfredson's research fields are chronic painful tendon conditions, especially the Achilles and patellar tendon, and treatment of cartilage injuries of the knee. Collaborative work with Radiology colleagues and Anatomy colleagues has led to the design of new treatment methods for the chronically painful Achilles and Patellar tendons, and also other tendons.
He is the author of over 150 published articles, working predominantly with Achilles and patella tendons, and he has been invited as a keynote speaker at international conferences in more than 20 countries.
Professor S. Peter Magnusson completed his Bachelors of Science, Physical Therapy at the University of Louisville, Kentucky, U.S.A in 1986. He also completed his Doctor of Medical Science, University of Copenhagen, Denmark in 1998.
Some of Professor Magnusson's committee work includes the Swedish Research Council (VR), Evaluation panel for musculoskeletal diseases and Anaesthesiology, and Radiology (2014-current). This also includes the Danish Ministry of Science, Evaluation of Nordic Sports Science Centers (2010-2011), and the UCSF strategy group (2011-2012). He worked with the Scientific Advisory Board for Danish Physical Therapists between 2009-2011, the Bispebjerg Hospital Research Council (2007- current), and the Copenhagen Capital Region Research Council (2007- current).
Professor Magnusson's main area of work focuses on tendon adaptation to loading, ageing and injury. He has contributed to and published 167 peer reviewed articles, three books and 12 book chapters and is Senior Researcher at the Institute of Sports Medicine Copenhagen and Bispebjerg Hospital also in Copenhagen.
Dr Graham Riley is a biochemist with a research focus on the molecular pathology of tendon.
A graduate of the University of Bristol, he has worked in a number of research areas in both academia and industry, including muscular dystrophy (Pasteur Institute, Paris), haemopoeitic stem cells (Institute of Cancer Research, London) and parasitology (Wellcome Laboratories, Beckenham).
Dr Riley completed his PhD at the Rheumatology Research Unit in Cambridge, investigating the biochemical changes that underlie chronic tendon pathology in the rotator cuff tendons of the shoulder. In 1996, he was appointed Head of the Soft Tissue Research Group at the Rheumatology Research Unit, and formed his own research group to investigate the cell and molecular pathology of tendons, ligaments and fascia.
Dr Riley has an international reputation in the field of tendon pathology, and has published a number of key papers. In particular, his work on the role and regulation of metalloproteinases in tendon matrix turnover has resulted in several well-cited publications, and his contribution to the field was recognised by the award of a Senior Research Fellowship from Arthritis Research UK in 2007. He brought his research group to UEA the same year.
Dr Ben Forster was educated in Brisbane and received his Medical Degree from the University of Queensland in 1991. He completed his orthopaedic training in 2000 and was admitted as a Fellow to the Royal Australasian College of Surgeons in that year.
His Fellowship Training was undertaken in Foot and Ankle surgery in Bristol, United Kingdom, knee surgery studies in Southampton, United Kingdom, and further training in Lecco, Italy. He has a special interest in sports and arthroscopic surgery.
Dr Forster is an Associate Clinical Lecturer with the Department of Orthopaedics at the University of Queensland. He is a member of the Australian Orthopaedic Foot and Ankle Society and ISAKOS. He has a public appointment at the Mater Hospital, South Brisbane. He is also involved with the Queensland Reds Rugby Union Team, Brisbane Lions AFL, Gold Coast Suns AFL, North Queensland Cowboys NRL, Gold Coast Titans NRL, along with the Queensland Ballet.
Dr Jonathan Rees graduated from the Royal London Hospital in 1995 and had postgraduate training at five London teaching hospitals. Between 2004 and 2012 he was a Consultant at Headley Court, the Defence Medical Rehabilitation Centre and Honorary Consultant Rheumatologist at Guy's and St Thomas' Hospitals.
Since 2012 Dr Rees has been Consultant in Rheumatology and Sports Medicine at Addenbrooke's Hospital, Cambridge. He is Honorary Senior Lecturer in Sport and Exercise Medicine at Queen Mary College, University of London.
He has worked in sports including Professional Football, Rugby Union and Disability Sport. Dr Rees was Medical Officer to the Great Britain 2008 Paralympic Team in Beijing. He was a member of the LOCOG Sports Medicine Advisory Group between 2008-2012 and a Consultant at the 2012 London Olympic Games.
Dr Rees' Medical Doctorate from University College London won the British Society of Sport and Exercise Medicine 2008 Basic Research Prize. He has published around 20 articles in peer review journals including highly cited articles in particular on tendinopathy.
Dr Rees regularly lectures nationally and internationally and has been interviewed by both BBC and ITN news. He is a Fellow of the Royal College of Physicians and a Founding Fellow of the Faculty of Sport and Exercise Medicine. He is a former President of the Royal Society of Medicine Sports and Exercise Medicine Section.
Professor Cathy Speed is a Consultant in Rheumatology, Sport and Exercise Medicine. She is also a Senior Physician for the English Institute of Sport, Chief Medical Officer to GB Badminton and to Middlesex County Cricket Club and the Academy at the Lords Ground, London. She is Professor of Sports Medicine at the University of St Mark & St John. Professor Speed trained at Nottingham, Newcastle, Durham and Cambridge and has done fellowships in the USA and Budapest.
Professor Speed's clinical practice blends both her specialities of Rheumatology and Sport & Exercise Medicine in the delivery of care. She has a particular clinical expertise in the diagnosis and management of complex musculoskeletal injuries, arthritis and recalcitrant tendinopathies in sport and in bone health in young athletes. Her academic interests include regenerative medicine in joint and tendon pathologies. She is active in teaching at undergraduate and postgraduate level and has published widely.
Mr Justin Coulter completed his undergraduate training at Wits in South Africa in 1995 and soon after moved to London.
He worked in the NHS for 2 years while also building a private practice and entered full time private practice in 1997. His interests lie in sports medicine, conservative management of foot and ankle disorders and the effects of hypermobility on foot function.
Mr Coulter has worked and continues to work with a multitude of sporting bodies including UK athletics, English Institute of Sport (EIS), England cricket, Saracens, Northampton Saints and Wasps Rugby Clubs as well as Premiership football. He also provides musculoskeletal podiatry services to The Royal Ballet and the English National Ballet.
This content consists of a 10 minute video presentation professionally produced and presented at the Fisic Conference 2015.
This content consists of a 15 minute video presentation professionally produced and presented at the Fisic Conference 2015.
Mr Callum Clark studied Medicine at Cambridge University graduating in 1993 and undertook his basic and higher surgical training in North West Thames London, including the Royal National Orthopaedic Hospital, where he developed his interest in foot and ankle surgery.
He spent a year of his training on a travelling Fellowship to Melbourne, Australia, where he gained further expertise in foot and ankle surgery and sports injuries. Upon his return, he worked briefly as a locum Consultant at the Royal National Orthopaedic Hospital before taking up the post of Consultant in Trauma and Orthopaedic Surgery at Heatherwood and Wexham Park Hospitals in 2004.
Mr Clark's surgical interests include arthritis and deformity correction, with a special interest in sports injuries and complex bunion and toe deformities. He holds the MFSEM (UK) qualification as a member of the Faculty of Sports and Exercise Medicine. He has an active involvement in research and education. He has published and presented both nationally and internationally on aspects of Foot and Ankle Surgery and has been principle investigator in a number of multi-centre trials. He is an elected member of the Education Committee of the British Orthopaedic Foot and Ankle Society (BOFAS) and regularly lectures to surgeons, general practitioners, physiotherapists and podiatrists both locally and nationally.
This article offers a ‘how to’ guide for diagnosing Achilles tendinopathy. We describe the differential diagnoses and look carefully at the history taking, examination methods and imaging techniques that are useful in diagnosing Achilles tendinopathy. The article is accompanied by a custom produced animation explaining the tendinopathy continuum, 7 professionally produced videos covering Achilles tendinopathy examination in standing and in lying, low dye taping, making temporary orthotics, eccentric loading and some case scenarios and a multiple choice quiz which results in the generation of a Pass certificate in the Quizzes area of your account on successful completion.
This article is an overview of a review by Malliaras et al. (1) looking at Achilles and patellar tendinopathy rehabilitation. There has been much research into the pathophysiology of tendinopathy and management of the condition has changed distinctly in the last 10 years. However, therapists are still using these old protocols (observed as little as 4 weeks ago) despite an incredible 45% of patients not responding significantly to eccentric exercise programmes. This article succinctly outlines the latest evidence base and rehab protocols and includes a video, animation and a continuing education multiple choice quiz.
In the October 2012 issue of sportEX medicine I reviewed the current evidence and theories relating to Achilles tendinopathy. While many theories are still in situ the one that appears to have gained the most traction, based on its pooling of current knowledge and clinical efficacy, is the tendinopathy continuum proposed by Cook and Purdam in 2009 (1). This article will look at the details of this paradigm using a specifically produced pathology animation and supportive images.
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