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Physio Foundations episode 2

Foundations of tendinopathy: with Peter Malliaras

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Episode details

Welcome to the second episode of Physio Foundations, a podcast about the knowledge and skills that provide the foundation of expert physiotherapy or clinical practice.

In this episode I talk to tendon expert and researcher Associate Professor Peter Malliaras from Monash University about how he built his foundations in physiotherapy practice and research and the most important things to consider for people with tendinopathy.


In this episode:

0:00 Introducing Peter Malliaras

2:05 Find your passion

2:44 Work with people you admire and want to work with

3:30 What are the fundamentals of tendinopathy?

4:50 Old ways of treating tendinopathy, oh my...

5:30 Be critical of your practice

6:30 Goals of management of tendinopathy

8:30 Why do people get tendinopathy?

11:10 Look broadly at the problem and the person

11:55 Foundations of physical examination

14:10 Avoid confirmation bias

16:05 People who measure and people who don't measure

18:30 Not everyone with tendinopathy will be weak

20:12 Prognosis. Who goes well, who takes longer? Psychosocial factors

23:20 Look how far we have come


View Peter's research profile here

Peter's tendinopathy website

Connect with Peter on Twitter @drpetemalliaras


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EPISODE summary

In this episode, Peter discusses the critical and evolving approach to understanding and treating tendinopathy. He begins by emphasizing the importance of critical thinking rather than blindly following established protocols. Reflecting on his early career, Peter recalls using outdated techniques like therapeutic ultrasound and frictions for tennis elbow. He shares a personal anecdote about his journey from being an uncritical new grad to a more informed professional, emphasizing the importance of understanding the basics and learning from experience.

Peter then highlights the significance of objective measurements in clinical practice. He believes that evidence-based treatment and gathering data from each patient is crucial for informed decision-making. He points out that while certain traditional variables like symptom duration or BMI may not have a direct bearing on the prognosis of tendinopathy, psychosocial variables might be more impactful. However, more research is needed in this area.

For tendinopathy treatment, Peter suggests a holistic approach, addressing not just the physical symptoms but also the psychological and social aspects. He underscores the importance of individualized treatment, taking into account factors like a patient’s strength, stress levels, health, and weight. Peter wraps up by reflecting on the evolution of tendinopathy treatment methods, from rudimentary techniques to today’s more informed practices.

This episode will be of interest to both new graduates and seasoned professionals, encouraging them to think critically, continually learn, and adopt a comprehensive approach to tendinopathy treatment.

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