About this episode
Chapters 00:00 Introduction and Current Work 02:51 Shockwave Therapy: Efficacy and Mechanisms 06:07 Understanding Tendon Pathologies 09:00 Calcification and Adaptation in Tendons 11:55 The Role of Shockwave in Clinical Practice 15:12 Platelet-Rich Plasma (PRP) Insights 18:06 Stem Cells and Tendon Healing 20:57 Adjuncts in Tendon Rehabilitation 23:48 Heel Wedges: Evidence and Application 27:06 Loading Strategies for Tendinopathy 30:04 Compression and Tendon Mechanics 32:56 The Importance of Loading in Rehabilitation 35:51 Tendon Stiffness: Heavy Loads vs. Plyometrics 42:01 Understanding Tendon Loading Mechanisms 45:25 Isometric vs. Eccentric Loading for Tendon Adaptation 48:23 Maximal Eccentrics: Techniques and Applications 51:45 Fluid Movement and Tendon Health 55:35 The Role of Metabolism in Tendon Adaptation 01:01:10 The Complexity of Tendon Pathology 01:06:29 The Dynamics of Fluid Movement in Tendons 01:11:11 Plyometrics vs. Isometrics: Strain and Adaptation 01:14:05 Blood Flow Restriction Training and Tendon Adaptation 01:18:21 Metabolic Factors in Tendon Healing Takeaways Peter Malairis is a full-time professor at Monash University. Recent research shows shockwave therapy is ineffective for tendon pain. Calcification in tendons may be an adaptive response. PRP injections do not outperform placebo treatments. Stem cell therapy lacks sufficient evidence for tendon healing. Adjunct therapies should be accessible, cheap, and safe. Heel wedges have shown significant effects in treating Achilles tendinopathy. Loading strategies must be tailored to individual patient needs. Tendon stiffness is primarily improved through heavy loading. Fluid movement within tendons is essential for adaptation. Loading the tendon heavier leads to better fluid movement. Isometrics are crucial for early rehabilitation stages. Heavy maximal eccentrics are key for long-term adaptation. Fluid movement impacts stress relaxation in tendons. Tendon stiffness increases with appropriate loading. Metabolic health is essential for tendon adaptation. Pathological tendons may require different loading strategies. Fluid movement can help reduce pain and improve function. Plyometrics may not provide sufficient strain for adaptation. Blood flow restriction can be effective for tendon rehabilitation. Website: https://www.tendinopathyrehab.com Instagram: https://www.instagram.com/tendinopathyrehab/?hl=en Twitter: https://x.com/DrPeteMalliaras Email: peter.malliaras@monash.edu Notes: https://jackedathlete.com/podcast-131-tendons-with-peter-malliaras/