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Exercise or loading interventions remain the conservative treatment of choice in the management of tendinopathy.1 However, as many as 60% of individuals experience continued symptoms, while up to a quarter of patients experiencing symptoms 10 years after treatment.2
What might explain these rather sobering outcomes? We opine that given the complex and often persistent nature of tendinopathy, addressing other factors in addition to exercise variables may prove beneficial. We focus here on the potential role of psychological factors.
Psychological factors have been implicated in many other musculoskeletal disorders, either as prognostic factors,3 as treatment effect modifiers4 or as mediators of recovery.5 As tendinopathy has been shown to be associated with psychological distress and poor quality of life,6 7 measuring psychological factors in randomised controlled trials (RCTs) of exercise would appear justifiable. This does not …
Footnotes
Twitter @Seaniemc89, @kieranosull, @RodWhiteley
Contributors All authors provided equal contribution to the composition of the manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.