• Physical Therapy Blog

Pain in the Butt, Sacroiliac Pain as Tendinopathy?

Pain in the Butt, Sacroiliac Pain as Tendinopathy?

I recently finished the 3rd edition Stuart McGill’s “Low Back Disorders.” I’ve followed his work since reading edition 2 and bulk of my back pain treatments are based on, or consistent with it and his more recent research. For those...

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Chad Reilly March 9, 2017 8 Comments

Coracoid Pain Test does NOT diagnose Adhesive Capsulitis

Coracoid Pain Test does NOT diagnose Adhesive Capsulitis

Coracoid pain test: a new clinical sign of shoulder adhesive capsulitis.Carbone S, Gumina S, Vestri AR, Postacchini R. Int Orthop. 2010 Mar;34(3):385-8. “Patients with adhesive capsulitis were clinically evaluated to establish whether pain elicited by pressure on the coracoid area...

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Chad Reilly December 19, 2016 1 Comment

Coracoidopathy Diagnosis Confirmed in New Study

Coracoidopathy Diagnosis Confirmed in New Study

This paper just came out in June this year confirming what I call coracoidopathy (tendinopathy of the short head of the biceps and coracobrachialis muscles where they attach at the coracoid process). They called it “coracoid syndrome,” which I might...

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Chad Reilly November 21, 2016 No Comments

Coracoid Impingement Syndrome and Coracoidopathy

Coracoid Impingement Syndrome and Coracoidopathy

This blog is probably only of interest to professionals since coracoid impingement syndrome (CIS) is thought to be a very rare, though important, shoulder pathology. CIS describes when the coracoid process is thought to physically impinge upon the lesser tuberosity...

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Chad Reilly June 24, 2016 1 Comment

Bench Press Shoulder Pain, Probably Coracoidopathy

Bench Press Shoulder Pain, Probably Coracoidopathy

I’ve done my share of bench presses, mostly back in my bodybuilder years before I got involved in Olympic weightlifting. Back then (well before I was a physical therapist) if someone in the gym had shoulder pain with bench press,...

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Chad Reilly June 3, 2016 6 Comments

Coracoidopathy: The Missing Link in Shoulder Pain

Coracoidopathy: The Missing Link in Shoulder Pain

To cut to the chase, coracoidopathy is an unbeknownst but common cause of shoulder pain. My preliminary data gathered from my shoulder pain referrals suggest it is present in up to 85% of people with shoulder pain. It is the...

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Chad Reilly May 23, 2016 6 Comments

Hip Pain, Trochanteric “Bursitis”/Tendinopathy, Exercise Best, Cortisone Worst

Hip Pain, Trochanteric “Bursitis”/Tendinopathy, Exercise Best, Cortisone Worst

This study was more interesting in its entirety than its abstract. I thought the home exercises given were beyond banal, but they still turned out best in the long term. Cortisone injected into tendons was yet again shown to be...

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Chad Reilly February 4, 2016 1 Comment

High Resistance / Weights Needed for Tendon Adaptation

High Resistance / Weights Needed for Tendon Adaptation

Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude. Arampatzis A1, Karamanidis K, Albracht K. J Exp Biol. 2007 Aug;210(Pt 15):2743-53. [FREE FULL TEXT] Abstract Tendons are able to remodel their mechanical and morphological...

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Chad Reilly November 23, 2015 3 Comments

Tennis Elbow, Strong Evidence AGAINST Platelet-Rich Plasma

Tennis Elbow, Strong Evidence AGAINST Platelet-Rich Plasma

Strong evidence against platelet-rich plasma injections for chronic lateral epicondylar tendinopathy: a systematic review. de Vos RJ, Windt J, Weir A. Br J Sports Med. 2014 Jun;48(12):952-6. Abstract BACKGROUND: Chronic lateral epicondylar tendinopathy is frequent in athletes, and platelet-rich plasma (PRP)...

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Chad Reilly September 8, 2015 No Comments

Low Level Laser Doesn’t Work for Tendinitis Either

Low Level Laser Doesn’t Work for Tendinitis Either

Clinical effectiveness of low-level laser therapy as an adjunct to eccentric exercise for the treatment of Achilles' tendinopathy: a randomized controlled trial. Tumilty S, McDonough S, Hurley DA, Baxter GD. From the Abstract OBJECTIVE: To investigate the effectiveness of low-level...

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Chad Reilly August 27, 2015 No Comments

Tennis Elbow and Treatment Frequency

Tennis Elbow and Treatment Frequency

Changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis caused by frequency of physical therapy: a randomized controlled trial. Lee S1, Ko Y1, Lee W1. J Physical Therapy Science. 2014 Jul;26(7):1037-40. [Free Full Text] Abstract [Purpose]...

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Chad Reilly May 27, 2015 No Comments

Strength Better than Stretch for Plantar Fasciitis

Strength Better than Stretch for Plantar Fasciitis

High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2014 Aug 21. Rathleff MS1, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, Jensen TT, Aaskov S, Olesen...

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Chad Reilly September 15, 2014 4 Comments

Foot Muscle Fatigue Causes Loss of Foot Arch

Foot Muscle Fatigue Causes Loss of Foot Arch

Fatigue of the plantar intrinsic foot muscles increases navicular drop. J Electromyogr Kinesiol. 2008 Jun;18(3):420-5.  Headlee DL, Leonard JL, Hart JM, Ingersoll CD, Hertel J. Abstract Our purpose was to assess the effect of foot intrinsic muscle fatigue on pronation,...

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Chad Reilly September 12, 2014 No Comments

Foot Intrinsic Muscles Important for Foot Arch

Foot Intrinsic Muscles Important for Foot Arch

Intrinsic pedal musculature support of the medial longitudinal arch: an electromyography study. J Foot Ankle Surg. 2003 Nov-Dec;42(6):327-33. Fiolkowski P, Brunt D, Bishop M, Woo R, Horodyski M. Abstract Much of the work describing support of the medial longitudinal arch...

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Chad Reilly September 12, 2014 No Comments

Plantar Fasciitis Sufferers Have Weaker Foot Muscles

Plantar Fasciitis Sufferers Have Weaker Foot Muscles

Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. J Orthop Sports Physical Therapy. 2003 Aug;33(8):468-78. Allen RH, Gross MT. Abstract STUDY DESIGN: Cross-sectional study. OBJECTIVE: To determine if a...

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Chad Reilly August 13, 2014 2 Comments

Plantar Fasciitis Associated with Foot Muscle Atrophy

Plantar Fasciitis Associated with Foot Muscle Atrophy

Use of MRI for volume estimation of tibialis posterior and plantar intrinsic foot muscles in healthy and chronic plantar fasciitis limbs. Chang R, Kent-Braun JA, Hamill J. Clin Biomech (Bristol, Avon). 2012 Jun;27(5):500-5. Abstract BACKGROUND: Due to complexity of the plantar...

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Chad Reilly August 11, 2014 No Comments

Plantar Fasciitis: Orthotics Don’t Help Much

Plantar Fasciitis: Orthotics Don’t Help Much

Effectiveness of foot orthoses to treat plantar fasciitis: a randomized trial. Arch Intern Med. 2006 Jun 26;166(12):1305-10. Landorf KB, Keenan AM, Herbert RD. Abstract BACKGROUND: Plantar fasciitis is one of the most common foot complaints. It is often treated with...

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Chad Reilly August 10, 2014 No Comments

Tennis Elbow: Both Concentric and Eccentric Exercise Helps

Tennis Elbow: Both Concentric and Eccentric Exercise Helps

A randomized controlled trial of eccentric vs. concentric graded exercise in chronic tennis elbow (lateral elbow tendinopathy). Clin Rehabil. 2014 Mar 14. [Epub ahead of print] Peterson M, Butler S, Eriksson M, Svärdsudd K. Abstract Objective:To analyse treatment effects of...

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Chad Reilly August 8, 2014 2 Comments

Shooter’s Elbow (aka Tennis Elbow / Golfer’s Elbow)

Shooter’s Elbow (aka Tennis Elbow / Golfer’s Elbow)

Shooter's elbow is a bit of a made up term. If it hurts on the outside of your elbow, then it’s the same as tennis elbow (lateral epicondylitis) and if it hurts on the inside of your elbow it's golfers...

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Chad Reilly June 9, 2014 97 Comments

Alfredson’s exercise program in Achilles tendinopathy 5 years later

Alfredson’s exercise program in Achilles tendinopathy 5 years later

A 5-year follow-up study of Alfredson's heel-drop exercise programme in chronic midportion Achilles tendinopathy. van der Plas A, de Jonge S, de Vos RJ, van der Heide HJ, Verhaar JA, Weir A, Tol JL. Br J Sports Med. 2011 Nov...

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Chad Reilly April 26, 2014 No Comments

Tennis Elbow: Improved with Isometric Exercise

Tennis Elbow: Improved with Isometric Exercise

Prospective evaluation of the effectiveness of a home-based program of isometric strengthening exercises: 12-month follow-up. Park JY, Park HK, Choi JH, Moon ES, Kim BS, Kim WS, Oh KS. Clin Orthop Surg. 2010 Sep;2(3):173-8. Epub 2010 Aug 3. Abstract BACKGROUND:...

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Chad Reilly April 26, 2014 No Comments

Cortisone, Eccentric vs Heavy Slow Resistance for Patellar Tendinopathy

Cortisone, Eccentric vs Heavy Slow Resistance for Patellar Tendinopathy

Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Kongsgaard M, Kovanen V, Aagaard P, Doessing S, Hansen P, Laursen AH, Kaldau NC, Kjaer M, Magnusson SP. Scand J Med Sci Sports. 2009 Dec;19(6):790-802. Epub...

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Chad Reilly April 25, 2014 4 Comments

Eccentric vs Eccentric Plus Shock-Wave Treatment for Achilles Tendinopathy

Eccentric vs Eccentric Plus Shock-Wave Treatment for Achilles Tendinopathy

Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: a randomized controlled trial. Rompe JD, Furia J, Maffulli N. Am J Sports Med. 2009 Mar;37(3):463-70. Epub 2008 Dec 15. Abstract BACKGROUND: Results of a previous randomized controlled...

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Chad Reilly April 24, 2014 No Comments

Eccentric Exercise and Heel Brace for Achilles Tendinopathy

Eccentric Exercise and Heel Brace for Achilles Tendinopathy

Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without the AirHeel Brace. A randomized controlled trial. A: effects on pain and microcirculation. Knobloch K, Schreibmueller L, Longo UG, Vogt PM. Disabil...

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Chad Reilly April 23, 2014 No Comments

Eccentric Exercise vs. Ultrasound for Achilles Tendo Pain

Eccentric Exercise vs. Ultrasound for Achilles Tendo Pain

Eccentric calf muscle training compared with therapeutic ultrasound for chronic Achilles tendon pain--a pilot study. Chester R, Costa ML, Shepstone L, Cooper A, Donell ST. Man Ther. 2008 Dec;13(6):484-91. Epub 2007 Jul 26. Abstract A number of studies have indicated...

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Chad Reilly April 22, 2014 No Comments

Eccentric calf muscle training in athletic patients with Achilles tendinopathy

Eccentric calf muscle training in athletic patients with Achilles tendinopathy

Eccentric calf muscle training in athletic patients with Achilles tendinopathy. Maffulli N, Walley G, Sayana MK, Longo UG, Denaro V. Disabil Rehabil. 2008;30(20-22):1677-84.  Abstract PURPOSE: To evaluate the effects of eccentric strengthening exercises (ESE) in athletic patients with Achilles tendinopathy....

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Chad Reilly April 21, 2014 No Comments

No Rest Necessary for Achilles Tendinopathy

No Rest Necessary for Achilles Tendinopathy

Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Am J Sports Med. 2007 Jun;35(6):897-906. Abstract BACKGROUND: Achilles tendinopathy is a common overuse...

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Chad Reilly April 20, 2014 No Comments

Anatomic factors related to the cause of tennis elbow

Anatomic factors related to the cause of tennis elbow

Anatomic factors related to the cause of tennis elbow. Bunata RE, Brown DS, Capelo R. J Bone Joint Surg Am. 2007 Sep;89(9):1955-63. Abstract BACKGROUND: The pathogenesis of lateral epicondylitis remains unclear. Our purpose was to study the anatomy of the...

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Chad Reilly April 19, 2014 No Comments

Eccentric exercise in treatment of Achilles tendinopathy

Eccentric exercise in treatment of Achilles tendinopathy

Eccentric exercise in treatment of Achilles tendinopathy. Nørregaard J, Larsen CC, Bieler T, Langberg H. Scand J Med Sci Sports. 2007 Apr;17(2):133-8. Abstract AIM: Prognosis and treatment of Achilles tendon pain (achillodynia) has been insufficiently studied. The purpose of the...

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Chad Reilly April 18, 2014 No Comments

Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy

Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy

Eccentric loading, shock-wave treatment, or a wait-and-see policy for tendinopathy of the main body of tendo Achilles: a randomized controlled trial. Rompe JD, Nafe B, Furia JP, Maffulli N. Am J Sports Med. 2007 Mar;35(3):374-83. Epub 2007 Jan 23. Abstract...

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Chad Reilly April 17, 2014 No Comments

Achilles Tendinopathy, Symptom Recovery Does Not Ensure Functional Recovery

Achilles Tendinopathy, Symptom Recovery Does Not Ensure Functional Recovery

Full symptomatic recovery does not ensure full recovery of muscle-tendon function in patients with Achilles tendinopathy. Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Br J Sports Med. 2007 Apr;41(4):276-80; discussion 280. Epub 2007 Jan 29. Abstract OBJECTIVE: To assess...

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Chad Reilly April 16, 2014 No Comments

Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy

Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy

Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy. Sayana MK, Maffulli N. J Sci Med Sport. 2007 Feb;10(1):52-8. Epub 2006 Jul 7. Abstract OBJECTIVE: Achilles tendinopathy is prevalent in athletes, but can also affect sedentary patients. We studied...

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Chad Reilly April 15, 2014 No Comments

Surgical Treatment vs. Eccentric Training for Jumper’s Knee

Surgical Treatment vs. Eccentric Training for Jumper’s Knee

Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper's Knee). A randomized, controlled trial. Bahr R, Fossan B, Løken S, Engebretsen L. J Bone Joint Surg Am. 2006 Aug;88(8):1689-98. Abstract BACKGROUND: Although the surgical treatment of patellar tendinopathy (jumper's...

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Chad Reilly April 14, 2014 No Comments

Tennis Elbow: Ice Has Zero Effect

Tennis Elbow: Ice Has Zero Effect

A controlled clinical pilot trial to study the effectiveness of ice as a supplement to the exercise programme for the management of lateral elbow tendinopathy. Manias P, Stasinopoulos D. Br J Sports Med. 2006 Jan;40(1):81-5. Abstract BACKGROUND: The use of...

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Chad Reilly April 13, 2014 No Comments

Jumper’s Knee, Eccentric Better than Concentric Exercise?

Jumper’s Knee, Eccentric Better than Concentric Exercise?

Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee: a prospective randomized study. Jonsson P, Alfredson H. Br J Sports Med. 2005;39(11):847-850. Abstract BACKGROUND: A recent study reported promising clinical results using eccentric quadriceps training...

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Chad Reilly April 12, 2014 No Comments

Standard PRE as Good as Eccentric Exercise for Jumper’s Knee in Season Volleyball

Standard PRE as Good as Eccentric Exercise for Jumper’s Knee in Season Volleyball

No effect of eccentric training on jumper's knee in volleyball players during the competitive season: a randomized clinical trial. Visnes H, Hoksrud A, Cook J, Bahr R. Clin J Sport Med. 2005 Jul;15(4):227-34. Abstract BACKGROUND: The effect of surgery on...

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Chad Reilly April 11, 2014 No Comments

Decline Squats for Volleyball Players with Patellar Tendinopathy

Decline Squats for Volleyball Players with Patellar Tendinopathy

Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Young MA, Cook JL, Purdam CR, Kiss ZS, Alfredson H. Br J Sports Med. 2005 Feb;39(2):102-5. Erratum in: Br...

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Chad Reilly April 10, 2014 No Comments

Eccentric Training and Neovascularisation in Achilles Tendinosis

Eccentric Training and Neovascularisation in Achilles Tendinosis

Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis? Ohberg L, Alfredson H. Knee Surg Sports Traumatol Arthrosc. 2004 Sep;12(5):465-70. Epub 2004 Apr 2. Abstract The background to the good clinical results reported using...

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Chad Reilly April 10, 2014 No Comments

Eccentric Calf Muscle Training for Achilles Tendinitis

Eccentric Calf Muscle Training for Achilles Tendinitis

Chronic Achilles tendon pain treated with eccentric calf-muscle training. Fahlström M, Jonsson P, Lorentzon R, Alfredson H. Knee Surg Sports Traumatol Arthrosc. 2003 Sep;11(5):327-33. Epub 2003 Aug 26. Abstract Injuries involving the Achilles tendon and manifested as chronic tendon pain...

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Chad Reilly April 9, 2014 No Comments

Decline Squats for Patellar Tendinopathy

Decline Squats for Patellar Tendinopathy

A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy. Purdam CR, Jonsson P, Alfredson H, Lorentzon R, Cook JL, Khan KM. Br J Sports Med. 2004 Aug;38(4):395-7. Abstract OBJECTIVES: This non-randomised pilot study...

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Chad Reilly April 8, 2014 No Comments