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#haliburton just ruptured his Achilles. This is devastating. He had dealt with a calf strain and ankle injury. Our research showed these injuries as accounting for 26% of prior injuries accounting for AT ruptures. I’d take the risk too for the finals, but this is a real risk.

How do I increase capacity then ? Would good rehab plan include reduced range for movement and progressing gripping strength ?

What’s your take on wrist flexor tendinopathy ? Increase capacity with wrist curls or treat as perri perri avoid aggrevating moves?

@ProfJillCook Should wrist tendinopathy be treated the same way as other tendon injuries? Iso for pain management and heavy slow curls &extensions ?

Would you say less weight (More about movement) and training twice a day with higher reps would be beneficial then ?

Interesting thread Every tendon is different in each person Subtleties in load prescription is the key skill of the clinician

Dr Cook I live in NYC …I’ve had chronic Achilles tendinosis for a decade I just started the heavy slow loading I’m wondering if you know anyone here in NYC that is best to help me rehab this Would be grateful for any help you could provide Thank you

It's counterintuitive... but true. Tendons want a heavy load. Even if painful. Isometric loads for hot tendons should be heavy, too. Bands ?? not so much... the springiness of the band can lead to forces that piss off tendons more. And read @ProfJillCook work...

So how would you know when to draw the line on how heavy to load a profoundly degenerative tendon if there are stories of people tearing tendons without any pain preceding the tear?

What do you say to those people who tear tendons off their bone while lifting heavy? They often report no pain until the moment it pops

Jill do you have a paper or article on this you can refer us to? 🙏🙏

In general you won’t be able to generate enough load… and at higher tensions it will bounce. And that will bother a hot tendon.

Would you address plantar fasciitis, please?

Awesome thank you! I just took a look through them! If HSR may not be required for successful therapy, when do you opt to use heavy loads? What are the other benefits?

I assume pulley injury (i.e. annular-ligament, not tendon), and strain/partial rupture? Would suggest slow progressively increased load below pain threshold. Hangboard (feet on initially) makes load very scalable. Tape could be beneficial? (doi.org/10.1186/s13102-022-0…)

Any advice can you load up an adductor longus enthesopathy “heavy”? Cheers

can you comment more about springiness linked to aggravating tendons? ive read work discussing holding vs pushing isometrics suggesting that holding may have more utility due to some oscillating contraction during the isometric which sounds counter to your point

A Shiny app dashboard inspired by the article “A Practical Approach to Managing Patellar Tendinopathy in the Competing Athlete.” Logs pain, trainings and rehab/strength exercises. carlos-jimenez31.shinyapps.i… @ProfJillCook @PhysioDMSilvan

AND stretching a tendon injury will usually make it worse

Appreciate your answer. Would you say that positive patella grind test, pain when rest and loaded and mixed results with isometrics (sometimes they do help sometimes not really ? Are symptoms of patella femoral pain?