Steven Low - Overcoming Tendonitis: A Systematic Approach to the Evidence-Based Treatment of Tendinopathy

Overcoming Tendonitis: A Systematic Approach to Evidence-Based Treatment of Tendinopathy

Copyright 2019 by Steven Low and Frank Skretch

All rights reserved.

Published in Houston, Texas, by Battle Ground Creative

First Edition

ISBN: 978-1-947554 -02-3 (softcover)

ISBN: 978-1-947554-03-0 (ebook)

HEALTH & FITNESS / Pain Management

Battle Ground Creative is a publishing company with an emphasis on helping first-time authors find their voice. Named after an obscure city in Washington State, we currently operate offices in Houston, Texas and Philadelphia, Pennsylvania. For a complete title list and bulk order information, please visit www.battlegroundcreative.com

The websites and references contained within this book are intended to serve as a resource with no guarantee expressed or implied as to the accuracy of their content.

Edited by Jared Stump

Cover design by Corinne Karl

Interior design and typeset by Katherine Lloyd

Printed in the United States of America

By using Overcoming Tendonitis (hereafter referred to as the book), you (hereafter referred to as the user), signify your agreement to the following terms and conditions. If you do not agree to the terms and conditions outlined on this page, do not use this book!

Material contained in the book is for educational purposes only. The authors, publisher, and other agents of the book assume no responsibility for any aspect of healthcare administered with the aid of content obtained from the book.

In no case shall the authors, illustrators, editors, publisher, suppliers, or any other third party referenced be liable for any damages (both now and in the future) including, but not limited to: physical injuries to any part of the body or multiple parts of the body, non-physical damages such as emotional pain and financial loss, tendon pain or damage, muscle strains or tears, illness and disease, heart attack, death; however caused, occurring during or after the users altering of their habits, actions, diet, exercise, and/or lifestyle based upon usage of the content provided by the book.

The users usage of any and all content provided within the book is at the users own risk. This includes suggested workouts, exercises, rehabilitation routines, nutritional information, and all other information.

User understands that any and all advice and suggested programs pertaining to tendons, rehabilitation, and exercise should be performed after consulting with the appropriate medical professionals, under the guidance of a qualified rehabilitation specialist.

User understands nutritional advice is not intended as a substitute for professional medical advice, diagnosis, and/or treatment, and has been advised to seek medical advice from a physician before altering a diet or beginning an exercise program.

T endonitis has been an interesting topic to research. When we looked at the efficacy of each treatment option for individual parts of the body, we were intrigued to find that the results varied. Treatments that worked slightly or moderately well for one form of tendonitis may work poorly or not at all for other types of tendonitis. Thus, as we reviewed the research, this book evolved from a big-picture look at different tendonitis treatment options to a specific integration of treatment options for different afflicted tendons.

As this book is a compilation of both research and expert opinions, we recommend that you talk to your doctor or medical professional before utilizing any of the information or suggestions presented in this book, as referenced in greater detail on the disclaimer page. The primary reason for this is because the information in this book is presented in a generalized manner based on what tends to work best for most of the population as an aggregate. Generalized information can be effective in many circumstances; however, your medical professional may recognize subtleties and/or intricacies of your case that could drive them to avoid certain types of treatment, utilizing other methods instead. This tends to be more effective than generalized treatment. At the same time, if your medical practitioners are not aware of some of the more recent research relating to tendonitis, it could likely help with your treatment to share some of the things you learn through this book.

Additionally, this book will not contain information about the diagnosis of tendinopathy, as we have found that many patients and athletes are inclined to self-diagnose their own injuries rather than see the appropriate medical professional. When it comes to tendinopathy in particular, this self-diagnosis is often inaccurate due to the complexity of the issues involved. Even if the tendinopathy diagnosis is accurate, there could be other factors or issues with ones technique that is contributing to it.

We hope that incidents of self-diagnosis will decrease. Please understand that use of any of the information presented in this book, apart from proper diagnosis and instruction from a medical professional, is strictly at your own risk and, in many cases, ill-advised.

Most medical professionals understand that research and expert opinions are constantly evolving and changing over time. We have worked diligently to gather not only a great deal of information but up-to-date information. However, there may be evidence we have failed to cover. If a medical professional were to discover clinically effective information that is not covered in this book, it would be beneficial for both them and their clients to use their experience and critical thinking skills to integrate it into their treatment plans.

In short, this book is not intended to be the end-all of knowledge and treatment of tendonitis.

Personally, we like to integrate the strongest research evidence, barring any contraindications, into the treatment plans we provide to our patients. If it fails to help them, we modify the plan as needed, and also integrate treatment plans that have shown to only work slightly to moderately well for the general population, as they may be highly effective for a specific individual. Given that one often will utilize different lines of evidence and treatments simultaneously, it is important to be on the lookout for areas where you can add or subtract treatments as the patient progresses or declines. The patient is the priority, not sticking to the plan.

Steven Low, DPT

Frank Skretch, DPT, CMTPT

Over the past ten to fifteen years, studies in physical therapy and other disciplines have begun classifying evidence according to various grades. This allows scientists to make more accurate observations about how scientific evidence may or may not apply to clinical guidelines and treatment. Below you will find a basic summary of how this evidence is classified for diagnostic, prospective, and therapeutic studies according to the Center for Evidence-Based Medicine.

This evidence can be compiled into a grading system that moves from A-D. Furthermore, the inclusion of expert opinion and scientific theoretical evidence means there are six different levels from A-F. These indicate the relative strength of any recommendations for application to clinical viability.