With August almost upon us, lots of people are mid-way through their training program for the annual City to Surf race. It is about this time of year where we see presentations of new onset tendon pain or flare ups in people who previously suffered with tendon issues.

Back in 2009 we were introduced to the “continuum of tendon pathology”, which sparked a lot of discussion around tendon pain and dysfunction. In this model tendon pathology fell under three categories:

1: Normal

2: Reactive

3: Tendon Disrepair.

Authors Cook and Purdam have since reflected on this framework. They have proposed that another stage may exist, where a tendon may have both reactive and degenerative components. But why does it matter what type of tendon pathology is present?

Because some treatment choices are more suited to specific stages of tendon pathology.

Below is a basic graphic outlining how we may target treatment in relation to this framework.

Adding or removing load will be the catalyst driving the tendon forward or backward on this continuum

In the lead up to City to Surf, be mindful of the duration, frequency and intensity of your training. If you have acutely overloaded with your running program, and are experiencing tendon pain at the hip, knee or ankle, come and discuss with one of our Physiotherapists.

Alison Molamphy

Physiotherapist