Are You Missing Out on the Latest Treatment for Overuse Injuries?
Dr. Katie Whetstone, PT, DPT, SCS, joins host Phil Plisky to discuss the latest treatment strategies for overuse injuries in athletes. Katie and Phil explore why these injuries persist, common treatment mistakes, and evidence-based approaches that emphasize tendon loading, rest-recovery cycles, and nutritional factors. Tune in for actionable insights to enhance your rehab approach and support athletes’ long-term performance.
1. Understand what is going on locally within the tissues, and treat locally with the best possible evidence.
- With tendinopathies, the most likely cause of the pain is NOT inflammation of the tissues; rather, it is the chronic degeneration in the midportion of the tendon that is driving the pain and dysfunction.
- The best treatment for tendinopathies is moderate loading exercises consisting of eccentric, concentric, and isometric exercises • Isometric exercises may have an analgesic effect and should be performed first when pain levels are high. Ő» Concentric exercises put a lighter load on the tissues than eccentric exercises and should be performed next when eccentrics are not yet tolerated.
- The research surrounding the use of eccentric exercises for the treatment of tendinopathies is extensive and longstanding. The goal should be to eventually include eccentrics in the treatment.
- Complete rest, NSAIDs, and corticosteroid injections are not recommended for tendinopathies as they may cause further degradation of the tissue.
2. Consider the implications of regional impairments. The tendinopathy is likely not the root cause. You need to systematically identify the root cause (consider SFMA)
3. The role of nutrition and recovery on the chronicity of overuse injuries such as stress fractures, stress syndromes, and tendinopathies.
- Relative energy deficiency in sport (RED-S) is a syndrome that results from problematic low energy availability (LEA). LEA is caused by a negative imbalance of caloric energy intake with exercise energy expenditure.
- Tendon recovery requires rest for 36–72 hours after an intense bout of exercise as this timeframe results in a net positive for protein synthesis. An athlete whose recovery time is less than 36 hours may still be in a net deficit of collagen regeneration when the next bout of exercise begins.
You can listen to the episode at the links below. If you'd like CEUs, make sure to use the MedBridge link.
