By Paul Blazey @Blazey85
This past week Canada got lucky. Professor Jill Cook, renowned for her contributions in tendinopathy research, visited from Australia and delivered a series of masterclass events across the country. Participants in Vancouver, Toronto and Montreal were in for a real treat. Below is a summary of their experience and some of my reflections (@blazey85) on the session in Vancouver.
The event kicked off on Friday 15thJune in Vancouver with a lecture on the latest updates in the field of tendinopathy, in particular the very latest research coming out from her Melbourne stable of highly regarded researchers and clinicians. Given the amount of experience Jill has in this area (also helping to formulate the careers of several other prominent tendinopathy experts) it was perhaps unsurprising that she had a clarity of view that sometimes eludes speakers. She was able to hold the full attention of a room of visitors from as far away as Alaska and Japan for a four-hour stretch full of clinical pearls. No mean feat.
Significant time was dedicated to covering the widely accepted ‘continuum theory’ of tendinopathy. One first postulated by Cook and Purdam (2009). We also looked at the steps required for clinicians to address tendinopathy by restoring strength, energy storage capacity and finally energy storage and release (Cook and Purdam, 2014).
This was all a bit of an appetizer. The following days, practical applications for managing tendinopathy in various settings were to be discussed!
Participants arrived back in Vancouver’s Center for Hip Health and Mobility bright and early on the Saturday morning, eager to continue, as you’ll see from the tweets below…
There was time for in-depth questioning and application to specific case studies where clinicians had come from differing backgrounds, including with rheumatological patients. We also covered further theory such as the neuroplastic effects of rehabilitation on tendinopathy (Rio, et al. 2015).
Events across all locations were extremely well received. With further feedback on social media demonstrating the maintenance of the high standards set in Vancouver and a high appreciation of the practical aspects of the course.
Firstly in Toronto…
And then the following weekend in Montreal, where a discussion on the importance of improving tissue capacity was again highlighted (Cook and Docking, 2015).
The masterclass linked research to practice in a fun and easy to understand format. For fellow professionals who live in far flung areas or whom were unable to make Jill’s talk in the flesh I would highly recommend listening to Jill’s talk on the continuum model of tendinopathy on the BJSM podcast from 2013 or engaging with any of the multiple papers published across the BJSM platform over the past decade such as her editorial on ‘ten treatments to avoid in patients with lower limb tendinopathy’ (Cook, 2018).
Link to podcast hosted by Prof Karim Khan, Jill answers questions she is commonly asked about the ‘continuum model’ of tendinopathy that she and Craig Purdam (Australian Institute of Sport) proposed:https://soundcloud.com/bmjpodcasts/jill-cook-on-the-continuum
Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J of Sports Med. 2009:43; 409-416
Cook JL, Purdam CR. The challenge of managing tendinopathy in competing athletes. Br J Sports Med 2014:48; 506-509
Rio E, Kidgell D, Moseley GL, et al. Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. Br J Sports Med. Published Online First: 25 September 2015. doi: 10.1136/bjsports-2015-095215
Cook J, Docking S. “Rehabilitation will increase the ‘capacity’ of your …insert musculoskeletal tissue here….” Defining ‘tissue capacity’: a core concept for clinicians. Br J Sports Med 2015;49: 1484-1485
Cook JL, Purdam CR. Is compressive load a factor in the development of tendinopathy? Br J Sports Med 2012:46; 163-168
Cook JL. Ten treatments to avoid in patients with lower limb tendon pain. Br J Sports Med Published Online First: 23 February 2018. doi: 10.1136/bjsports-2018-099045