075. Tendinopathy, imaging and diagnosis with Dr Sean Docking

Tendinopathy patients may present for treatment with an ultrasound or MRI report in hand, unsure how you can help them, or how they can possibly recover when they have so much tendon pathology. To add insult to injury, they may even have a partial tendon tear on their imaging report thrown into the mix. How do imaging results impact your treatment and your patient's recovery? Are the imaging findings relevant to their pain?

In this Physio Edge podcast with Dr Sean Docking (Physiotherapist, PhD), you will explore what information imaging actually provides in your tendinopathy patients, how to explain imaging to your patients, and whether partial tendon tears identified on imaging will effect your treatment. You will also discover:

• Who develops tendon pathology
• If patients have tendon pathology on imaging, is this responsible for their symptoms, or will it cause future tendon pain
• Asymptomatic tendon pathology in sports people
• How tendon pathology can actually be linked to better performance
• Can we prevent tendon pathology
• The advantages and disadvantages of different imaging types, including
• MRI
• Ultrasound
• Ultrasound tissue characterisation (UTC)
• Why a thickened tendon may actually be helpful in recovery
• How can we actually diagnose tendinopathy
• When is imaging useful
• Differential diagnosis of Achilles pain, including - Achilles tendinopathy - Paratenonitis - Plantaris associated tendinopathy
• Partial tendon tears, the accuracy of identification, and how they impact your treatment

Links associated with this episode:

• Twitter - @SIDocking
• Sean Docking - La Trobe University website
• Sean Docking - Research gate
• David Pope on Twitter
• Clinical Edge on Facebook
• Have a free trial Clinical Edge membership

Articles associated with this episode:

Alfredson. 2011. Midportion achilles tendinosis and the plantaris tendon

Brown et al. 2011. The COL5A1 gene, ultra-marathon running performance and range of motion

Docking et al. 2016. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC).

Docking et al. 2015. Tendinopathy: Is imaging telling us the entire story?

Lieberthal et al. 2014. Asymptomatic achilles tendinopathy in male distance runners

McAuliffe et al. 2016. Can ultrasound imaging predict the development of Achilles and patellar tendinopathy? A systematic review and meta-analysis

Simpson et al. 2016. At What Age Do Children and Adolescents Develop Lower Limb Tendon Pathology or Tendinopathy? A Systematic Review and Meta-analysis

Other episodes of interest:

PE 068 - Lower limb tendinopathy loading, running and rehab with Dr Pete Malliaris

PE 042 - Treatment of Plantaris and achilles tedninopathy with Seth O’Neil

PE 041 - Plantaris involvement in achilles tendinopathy with Dr Christoph Spang