Test Your Knowledge - Physical Therapy Management of Tendinopathies

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* 1. A 20-year-old soccer player belongs to a team for which you are the physical therapist. The player reports a several-day history of mild patellar tendon pain. The tendon is painful with palpation but there is no deficit in strength or functional movements. Without ordering imaging, what would you predict for this tendon’s prognosis?

50-50 success rate with non-surgical management.

Likely need for arthroscopic debridement of tendinopathic tissue.

Median return to play of 1 week.

12-week return to play expected.

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* 2. A 40-year-old mechanic who works on in-built boat engines presents with lateral elbow pain. What factor do you hypothesize as most likely to be contributing to his elbow pain?

High external forces and manual handling greater than 4.5 kg.

Low level of education.

Catastrophizing about the severity of his injury.

Widespread mechanical hyperalgesia.

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* 3. Which patient will be least likely to complain of patellar tendon pain, based on their current activity level?

The patient who works as a delivery-person and must negotiate ≥6 flights of stairs and get in and out of their truck ≥20 times throughout their workday.

The patient who plays varsity volleyball and starts their season with a weekend tournament consisting of 4 games.

The patient who has joined a recreational basketball league for the first time and plays for 2 hours, twice per week.

The patient who has been running 15-20 miles per week but has now decided to add speed and hill training into their routine.

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* 4. Which type of loading is best at increasing the Achilles tendon’s stiffness and cross-sectional area?

Isometric exercise.

Eccentric exercise.

Higher loads with longer duration.

Lower loads with short duration.

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* 5. In the physical examination of a patient with lateral hip pain, which group of tests is most useful for ruling in gluteal tendinopathy when the tests are positive?

The Ober test, palpation of the greater trochanter, and the single leg stance test.

The single leg stance test, FADER-R (flexion/adduction/external rotation + resisted internal rotation), and ADD-R (resisted abduction).

Single leg stance test, FABER (flexion/abduction/external rotation) test, and palpation of the greater trochanter.

Palpation of the greater trochanter, FABER test, and ADD (passive hip adduction).

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