Surgery or Physical Therapy For tendinopathy

Tendinopathy can be challenging to manage and have a significant impact. There’s growing evidence that education, load management and progressive rehab can be effective but it’s often a slow process. So how long do you persist? When might you consider other options such as surgery?

A new systematic review from @challoumasofficial and colleagues just published in @bjsm_bmj has found that physiotherapy is as effective as surgery both in the midterm and longterm for pain, function and quality of life.
This review looked at 7 shoulder studies, 3 studies for the elbow, 1 study for the knee and 1 study for the achilles. Over 1000 participants were included in this review.

The authors recommended that we use evidence-based loading for 12 months before considering surgery. This is great news and supported by other research which suggests we should be patient and give people with tendon pain the time and rehab they need to recover.

Challoumas et al. 2019


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