Tendons with Peter Malliaras

Chapters 00:00 Introduction and Current Work 02:51 Shockwave Therapy: Efficacy and Mechanisms 06:07 Understanding Tendon Pathologies 09:00 Calcification and Adaptation in Tendons 11:55 The Role of Shockwave in Clinical Practice 15:12 Platelet-Rich Plasma (PRP) Insights 18:06 Stem Cells and Tendon Healing 20:57 Adjuncts in Tendon Rehabilitation 23:48 Heel Wedges: Evidence and Application 27:06 Loading Strategies for Tendinopathy 30:04 Compression and Tendon Mechanics 32:56 The Importance of Loading in Rehabilitation 35:51 Tendon Stiffness: Heavy Loads vs. Plyometrics 42:01 Understanding Tendon Loading Mechanisms 45:25 Isometric vs. Eccentric Loading for Tendon Adaptation 48:23 Maximal Eccentrics: Techniques and Applications 51:45 Fluid Movement and Tendon Health 55:35 The Role of Metabolism in Tendon Adaptation 01:01:10 The Complexity of Tendon Pathology 01:06:29 The Dynamics of Fluid Movement in Tendons 01:11:11 Plyometrics vs. Isometrics: Strain and Adaptation 01:14:05 Blood Flow Restriction Training and Tendon Adaptation 01:18:21 Metabolic Factors in Tendon Healing   Takeaways Peter Malairis is a full-time professor at Monash University. Recent research shows shockwave therapy is ineffective for tendon pain. Calcification in tendons may be an adaptive response. PRP injections do not outperform placebo treatments. Stem cell therapy lacks sufficient evidence for tendon healing. Adjunct therapies should be accessible, cheap, and safe. Heel wedges have shown significant effects in treating Achilles tendinopathy. Loading strategies must be tailored to individual patient needs. Tendon stiffness is primarily improved through heavy loading. Fluid movement within tendons is essential for adaptation. Loading the tendon heavier leads to better fluid movement. Isometrics are crucial for early rehabilitation stages. Heavy maximal eccentrics are key for long-term adaptation. Fluid movement impacts stress relaxation in tendons. Tendon stiffness increases with appropriate loading. Metabolic health is essential for tendon adaptation. Pathological tendons may require different loading strategies. Fluid movement can help reduce pain and improve function. Plyometrics may not provide sufficient strain for adaptation. Blood flow restriction can be effective for tendon rehabilitation.   Website: https://www.tendinopathyrehab.com Instagram: https://www.instagram.com/tendinopathyrehab/?hl=en Twitter: https://x.com/DrPeteMalliaras Email: [email protected] Notes: https://jackedathlete.com/podcast-131-tendons-with-peter-malliaras/

Chapters 00:00 Introduction to Tendon Research and Background 02:51 Understanding Tendon Mechanics and Strain 06:14 The Role of Tendons in Human Movement 09:07 Tendon Strain: Hierarchical Structure and Function 11:58 The Impact of Load and Speed on Tendon Behavior 15:08 Exploring Tendon Creep and Adaptation 18:05 Mechanotransduction and the Importance of Time 21:01 Pediatric Tendon Development and Muscle-Tendon Imbalance 24:00 Training Tendons: Strength vs. Plyometrics 26:46 Viscoelasticity and Tendon Behavior 30:14 Conclusion and Future Directions in Tendon Research 37:42 Understanding Tendon Behavior: Elasticity vs. Viscosity 42:04 The Sweet Spot of Tendon Strain 47:15 Blood Flow Restriction: Mechanisms and Efficacy 52:18 Tendon Compliance: Training and Adaptation 57:06 Passive Stretching: Effects on Tendon Adaptation 01:01:17 Training Age and Tendon Stiffness 01:06:29 Sex Differences in Tendon Adaptation 01:11:03 Future Directions in Tendon Research   Takeaways Dr. McMahon's background includes a PhD in tendon mechanics. Tendons are part of a muscle-tendon-bone complex. Tendon strain is the relative change in length compared to its original length. Tendons have their own metabolism, albeit at a lower scale than muscles. The hierarchical structure of tendons serves to protect against stress. Tendon stiffness can increase with load and speed of movement. Creep occurs under constant load, affecting tendon length over time. Mechanotransduction requires time for effective cellular response. Pediatric tendon development may lead to imbalances with muscle strength. Strength training is more effective for tendon adaptation than plyometrics. Tendon behavior involves both elasticity and viscosity simultaneously. There is a sweet spot for tendon strain duration, ideally between 3 to 15 seconds. Longer isometric holds may not benefit healthy tendons. Blood flow restriction (BFR) may not have unique benefits over traditional training. Tendon compliance can be improved by reducing resistance training. Passive stretching may yield some adaptation in untrained individuals. Training age influences tendon stiffness and adaptation. Sex differences exist in tendon adaptation, with females gaining stiffness at lower force levels. The relationship between training volume and tendon adaptation is complex and requires more research. Understanding how tendons perceive strain is crucial for future studies.    Gerard on Twitter: https://x.com/gerdy_mac Notes:  https://jackedathlete.com/podcast-130-tendons-with-gerard-mcmahon/

Chapters 00:00 Introduction to Circadian Rhythms and Skeletal Muscle 02:52 Understanding the Circadian Clock 06:12 Dysregulation of Circadian Rhythms 09:06 Impact of Inflammation on Circadian Clocks 12:00 Peripheral Clocks and Their Independence 15:06 Exercise Timing and Performance 18:06 Feeding Patterns and Circadian Rhythms 21:00 Chronotypes and Individual Differences 23:59 Caffeine and Its Effects on the Clock 27:02 Adaptation of Circadian Clocks in Extreme Conditions 29:58 Alcohol's Impact on Circadian Function 31:01 The Impact of Circadian Clocks on Muscle and Tendon Health 36:34 Aging and Its Effects on Circadian Rhythms 40:47 Injury and Circadian Clocks: Understanding the Connection 43:10 The Role of Nutrition and Feeding Patterns 48:29 Circadian Disruption and Metabolic Health 51:50 Practical Applications for Maintaining Healthy Clocks   Takeaways Circadian clocks are molecular timers found in every cell. The clock regulates metabolism and gene expression based on time of day. Dysregulation can lead to health issues like increased glucose levels. Peripheral clocks can operate independently of the central clock. Exercise timing can enhance performance and adaptation. Feeding patterns should align with activity for optimal health. Chronotype influences individual preferences for sleep and activity. Caffeine affects the sympathetic nervous system but doesn't phase shift the clock. Alcohol can disrupt circadian function and health. Adaptation of clocks can occur even in extreme light conditions. Circadian clocks significantly influence muscle and tendon health. Disruption of circadian rhythms can lead to metabolic issues. Aging affects the ability of circadian clocks to regulate gene expression. Inactivity does not stop circadian clocks, but it affects their function. Nutrition timing is crucial for maintaining healthy circadian rhythms. Exercise can enhance the function of circadian clocks in muscles. Understanding the communication between muscle and tendon is vital for rehabilitation. Time-restricted feeding may extend lifespan and improve health. Research on circadian rhythms can inform strategies for injury recovery. Maintaining a consistent activity and feeding schedule supports clock health. Karyn's profile: https://physiology.med.ufl.edu/profile/esser-karyn/ Karyn's Linkedin: https://www.linkedin.com/in/karyn-esser-a187333 Notes: https://jackedathlete.com/podcast-129-circadian-rhythms-with-karyn-esser/

Chapters 00:00 Introduction to Tendon Research 02:59 The Evolution of Tendon Rehabilitation 06:07 Understanding Tendon Mechanics and Training Approaches 09:00 The Role of Load in Tendon Health 12:03 Aging and Tendon Structure 14:51 The Impact of Immobility on Tendon Health 18:09 Stages of Tendon Development 21:08 Tendon Ruptures and Age Factors 24:00 The Science of Tendon Stiffness 26:46 Cellular Dynamics in Tendon Health 32:26 Understanding Tendon Responses: Achilles vs. Patellar 36:11 The Role of Cross-Links in Tendon Stiffness 40:59 Exercise and Its Impact on Tendon Health 42:25 Dietary Influences on Tendon Integrity 44:17 Metabolic Syndrome and Tendon Health 46:38 Accumulation of Advanced Glycation End Products 49:31 Tendon Size and Vascularization in Tendinopathy 54:51 Inflammation in Tendon Pain: A Complex Relationship 01:00:07 Circadian Rhythms and Tendon Health 01:03:27 Future Research Directions in Tendon Studies   Takeaways Christian Coupe is a physical therapist and researcher. He has worked extensively with elite athletes, particularly in racket sports. Tendon issues like jumpers knee and Achilles tendinopathy are common in athletes. Eccentric training was a breakthrough in tendon rehabilitation. Heavy slow resistance training may be more effective than eccentric training. Tendons require regular loading to maintain health and prevent degradation. Aging begins around the age of 17, affecting tendon structure and function. Immobility can lead to rapid deterioration of tendon health. Tendon stiffness is crucial for performance and injury prevention. There is potential for improving tendon health even in older individuals.  The Achilles tendon may require different loading than the patellar tendon. Cross-links in tendons can affect stiffness and brittleness. Exercise is crucial for maintaining tendon health and properties. Dietary choices can influence tendon integrity and health. Metabolic syndrome is linked to tendon issues and injuries. Advanced glycation end products accumulate in low turnover tissues like tendons. Tendon size can increase due to vascularization in tendinopathy. Inflammation may be present in early stages of tendon pain. Circadian rhythms could play a role in tendon recovery processes. Future research should focus on the metabolic aspects of tendon health.   Christian's research (Researchgate): https://www.researchgate.net/profile/Christian-Couppe Christian's profile: https://researchprofiles.ku.dk/en/persons/christian-couppé Christian on Twitter: https://x.com/ccouppe

Chapters 00:00 Introduction to Tendinopathy Coaching 03:10 The Journey into Tendon Rehabilitation 06:08 Understanding Muscle-Tendon Imbalance 09:01 Pain vs. Structural Changes in Tendons 11:55 The Complexity of Pain Management 14:45 The Role of Dynamic Loading in Recovery 18:04 Differentiating Between Patellar Tendinopathy and Patellofemoral Pain 20:50 Mid-portion vs. Insertional Achilles Tendinopathy 42:37 Gradual Exposure in Tendon Rehabilitation 45:03 Frequency and Loading in Tendon Rehab 49:27 Metabolic vs. Load-Related Tendon Pain 55:40 Inflammation and Pain Mechanisms in Tendons 01:01:01 The Role of Alcohol in Tendon Pain 01:07:14 Strength vs. Load Management in Tendon Recovery 01:13:32 Future Directions in Tendon Research Takeaways Niels Heim's journey into tendinopathy coaching began with a podcast. Coaching focuses on helping athletes return to their sport. Pain management in tendinopathy is complex and individualized. Dynamic loading is crucial for tendon recovery. Differentiating between patellar tendinopathy and patellofemoral pain is important. Muscle-tendon imbalances can lead to injuries. Structural changes in tendons do not always correlate with pain relief. Isometric loading can be beneficial for tendon rehabilitation. Understanding patient-specific pain responses is essential. The approach to Achilles tendinopathy should differentiate between mid-portion and insertional types. Gradual exposure to loading can enhance tendon rehabilitation. Frequency of loading is crucial; every other day may be optimal. Metabolic and load-related tendon pain require different approaches. Inflammation is not always the primary concern in tendon pain. Alcohol consumption can exacerbate tendon pain. Strength may not need to increase for recovery to occur. Managing overall load is essential for tendon health. Eliminating negative lifestyle factors can aid recovery. Pain management strategies are vital in rehabilitation. Future research should explore plyometric training frequency.  Nils on Instagram: https://www.instagram.com/nils.heim.schmerzcoach/ SehnenStark podcast (iTunes): https://podcasts.apple.com/us/podcast/sehnenstark/id1725984010 SehnenStark podcast (Spotify): https://open.spotify.com/show/63h1RG0X1ZCoWwT3Z0MgZ1?si=b0193eed8f604635 Notes here: https://jackedathlete.com/podcast-127-tendons-with-nils-heim/

Chapters 00:00 Introduction to Coaching and Background 02:47 The Importance of Plyometrics in Training 06:13 Understanding Tendon Development and Injury Risks 08:58 The Role of Volume in Athletic Training 11:47 Exploring Isometric Training Techniques 15:10 Tendon Issues in Young Athletes 18:02 Biomechanics and Injury Prevention 20:56 The Journey with Extreme Isometrics 24:08 Experiences and Outcomes from Isometric Training 30:20 Embracing Failure in Training 32:51 The Neurological Aspect of Muscle Coordination 36:12 Understanding Energy Systems in Training 37:06 Optimizing Leg Positioning for Performance 39:55 The Role of Tendons in Rehabilitation 43:07 Balancing Loading Techniques for Tendon Health 46:03 The Impact of Blood Flow on Tendon Recovery 48:50 Integrating Plyometrics and Isometrics in Training 52:13 Foot Mechanics and Injury Prevention 57:55 Conclusion and Resources   Takeaways Rob Assisi has been a track coach for 21 years. Plyometrics play a crucial role in athletic adaptation. There needs to be a balance between stiffness and compliance in training. Volume is essential for tendon development. Isometric training can provide unique benefits for athletes. Young athletes often face tendon issues due to overtraining. Biomechanics significantly influence injury risks in athletes. Extreme isometrics can lead to remarkable performance improvements. Understanding foot contact is vital for effective training. Coaches must consider the long-term effects of training on athletes.  Embracing failure is crucial for growth in training. Pulling harder can help overcome feelings of impending failure. Muscle coordination is key to effective training. Energy systems play a significant role in performance. Tendons require specific loading techniques for rehabilitation. Long-duration holds can benefit tendon health. Blood flow restriction may aid in tendon recovery. Integrating different training modalities enhances performance. Foot mechanics are essential for injury prevention. Understanding individual biomechanics can improve training outcomes.   Rob's Instagram: https://www.instagram.com/reevolutionathletics/ Rob's Twitter: https://x.com/hfjumps Rob's Website: https://www.re-evolutionathletics.com/home

Chapters 00:00 Introduction to Greg Lehman's Approach 03:06 Understanding Tendinopathy and Its Implications 05:59 The Role of Tendon Stiffness in Rehabilitation 09:06 The Complexity of Tendon Rehabilitation 12:01 The Importance of Individualized Treatment Plans 15:03 Exploring the Connection Between Metabolic Health and Tendon Pain 17:59 The Debate on Stretching and Tendon Health 21:04 Compression and Its Effects on Tendons 24:06 Managing Activity Levels During Rehabilitation 26:54 Evaluating Loading Protocols for Tendon Recovery 30:08 Muscle-Tendon Imbalance and Injury Risk 33:10 Research Insights on Tendon Adaptation 36:34 Understanding Tendon Strain Dynamics 39:04 Exploring Tendon Rehabilitation Protocols 42:54 The Role of Muscle in Tendon Health 46:24 Isometrics and Their Evolving Role in Rehab 56:36 Patient-Centered Care in Tendon Rehabilitation   Takeaways The diagnosis often does not dictate treatment in rehab. Tendon stiffness is a key factor in rehabilitation. Individualized treatment plans are crucial for effective rehab. Metabolic health can significantly impact tendon pain. Stretching may still have a role in tendon health. Compression effects on tendons are complex and not fully understood. Maintaining activity levels can be beneficial during rehab. Loading protocols should be tailored to the individual. Muscle-tendon imbalances can increase injury risk. Research continues to evolve our understanding of tendon adaptation. Tendon strain is influenced by joint angle and muscle contraction. Isometric holds may not be the only effective method for tendon rehabilitation. Patient-centered care is crucial in designing rehabilitation programs. Performance goals should be integrated into rehabilitation strategies. Muscle strength plays a significant role in tendon health and recovery. The body can adapt to protect injured areas, complicating rehabilitation. Isometrics can provide analgesic effects, but results vary among individuals. Conscious isolation of muscle groups may be necessary for effective rehab. Tendons respond to load, regardless of the type of contraction used. Understanding individual patient goals is essential for effective treatment.   Greg's Website: https://www.greglehman.ca Greg's Linktree: https://linktr.ee/greglehman?fbclid=PAZXh0bgNhZW0CMTEAAaY1JK0-KyV8C2O6j4k0Nv2xCnekXbXyAyevDP_vAwhwrFPt-vdPlgeJV6U_aem_5GCz-V50wzOwW-ZtfDIKzw Greg's Instagram: https://www.instagram.com/greglehman/ Greg's Twitter: https://x.com/GregLehman?ref_src=twsrc%5Egoogle%7Ctwcamp%5Eserp%7Ctwgr%5Eauthor Notes here: https://jackedathlete.com/podcast-125-tendons-with-greg-lehman/

Chapters 00:00 Introduction to Tendon Talk 01:55 Understanding Patellofemoral Pain 06:02 The Biopsychosocial Model in Pain Management 09:57 The Role of Muscle Strength in Tendon Health 13:54 Exploring Achilles Tendinopathy 17:55 Calf Raises and Their Effectiveness 22:04 The Importance of Loading in Rehab 26:05 Comparing Patellar and Achilles Tendon Rehab 29:57 Final Thoughts on Tendon Management 38:20 Rehabilitation Challenges with Achilles and Patellar Ruptures 41:23 Innovative Techniques in Achilles Rehabilitation 44:09 The Debate on Literature vs. Real-World Experience 49:15 Personal Experiences with Achilles Injuries 53:30 Genetics and Tendon Injuries 57:07 Understanding Partial Ruptures vs. Tendinopathy 01:00:11 Pain Response in Achilles Rehabilitation 01:02:29 The Role of Pain in Rehabilitation 01:04:50 Loading Techniques for Achilles Rehabilitation 01:09:21 Exploring Jerk Isometrics in Rehabilitation 01:10:46 The Value of Isometrics in Rehabilitation 01:11:11 Surface Variation in Achilles Rehab 01:12:04 Manipulating Center of Mass for Rehab 01:15:24 Encouraging Movement Variety in Rehabilitation 01:16:14 Understanding Tendon Mechanics and Mobility 01:18:14 The Role of Heel Wedges in Pain Relief 01:19:35 Insights on Upper Body Tendon Rehabilitation 01:22:08 Exploring Movement Variability in Upper Limbs 01:31:06 The Importance of Variety and Variability in Movement 01:35:35 Upcoming Programs and Workshops   Takeaways David discusses the challenges of managing time and opportunities in his work. Jake shares his personal experience with weight loss and its impact on his social life. David explains his approach to treating patellofemoral pain and the importance of loading. The conversation highlights the biopsychosocial model in understanding pain. David emphasizes the need for less frequent loading for patellofemoral pain compared to tendon pain. Jake questions the structural understanding of patellofemoral pain and its implications for rehab. David shares his personal journey with Achilles tendinopathy and its impact on his athletic performance. The discussion reveals the common pitfalls in calf raise exercises for Achilles rehab. David advocates for high intensity and low frequency in calf raise training. The conversation concludes with insights on the differences between patellar and Achilles tendon management. Rehabbing an Achilles rupture requires careful management of tendon lengthening. Overcoming isometrics are effective for strengthening the Achilles during rehab. Real-world experiences can often contradict existing literature on rehabilitation. Personal experiences with tendon injuries highlight the unpredictability of recovery. Genetics may play a significant role in tendon injuries and recovery. Partial ruptures should be approached with caution, similar to tendinopathy. Pain response is less significant in Achilles rehabilitation compared to other injuries. It's crucial to focus on loading techniques rather than just range of motion. The literature on tendon injuries can be misleading and should be interpreted with caution. Effective rehabilitation requires pushing patients as hard as possible without exceeding their limits. Isometrics can clarify what's working in rehab. Varying surfaces can enhance Achilles rehab. Manipulating center of mass is crucial for rehab. Movement variety is often overlooked in rehab. Tendon mechanics play a significant role in recovery. Heel wedges can provide relief for insertional pain. Upper body tendons require a different approach. Movement variability is essential for upper limb function. Older athletes often lack movement variety and variability. A holistic approach to rehab includes strength, mobility, and control.   David's Website: https://davidgreyrehab.com David's Instagram: https://www.instagram.com/davidgreyrehab/?hl=en Notes: https://jackedathlete.com/podcast-124-tendons-with-david-grey/  

Chapters 00:00 Moving to Tennessee: A New Chapter 05:12 Understanding the Tier System for Plyometrics 10:06 The Importance of Tendon Health in Sports 14:55 Exploring Structural Changes in Muscle and Tendon 19:58 Volume vs. Intensity: The Key to Structural Development 24:59 The Role of Joint Stiffness in Athletic Performance 30:02 The Stretch-Shorten Cycle and Its Implications 35:16 Understanding Tendon Development 39:01 The Neuromuscular Connection 44:07 Stiffness vs. Compliance in Tendons 48:01 The Importance of Deep Tier Movements 56:56 Tendon Development in Youth 01:04:00 Upcoming Projects and Future Plans   Takeaways Matt recently moved to Knoxville, Tennessee, and is working with the NFL Combine Group. The tier system for plyometrics is based on a simple classification of movement intensity. Tendon health is crucial for athletes, especially in track and field. Volume is essential for structural development in muscles and tendons. Joint stiffness plays a significant role in athletic performance. The light tier of plyometrics is more muscular-based and less effective for structural changes. High volumes of plyometric training can lead to significant improvements in performance. Athletes in team sports often hide injuries better than those in track and field. The stretch-shortening cycle is vital for understanding tendon function during athletic movements. Fatigue in muscles can limit the effectiveness of tendon utilization during performance. Max effort jumps primarily enhance neuromuscular output. Tendon development requires specific training tiers. Stiffness and compliance are crucial for tendon health. Deep tier movements may improve tendon compliance. Youth training should consider peak height velocity. Monitoring volume and intensity is essential for young athletes. Tendons behave differently in youth compared to adults. Injury prevention strategies must include structural training. The relationship between joint angles and tendon strain is complex. Upcoming courses will focus on practical training methods.    Matt's Website: https://www.plusplyos.com Matt's Instagram: https://www.instagram.com/mcinneswatson/?hl=en Notes: https://jackedathlete.com/podcast-123-tendons-with-matt-mcinnes-watson/

Chapters 00:00 Introduction and Personal Updates 02:58 Child Development and Movement Efficiency 05:46 Rock Climbing Insights and Tendon Health 09:10 The Importance of Volume in Training 11:53 Integrating Fun into Training 14:46 Seasonal Training Adjustments 18:10 Managing Tendon Health and Injury Prevention 25:14 Evolving Training Approaches 27:40 The Importance of Timing in Athletic Performance 28:10 Utilizing Music and Rhythm in Training 31:30 Exploring Flywheel Training and Tendon Health 33:20 Understanding Finger Tendon Development 39:08 Personal Experiences with Achilles Issues 49:30 Prehab Strategies for Achilles Health 53:37 Exploring Variability in Training 56:48 Understanding Tendon Issues in Athletes 01:00:24 The Mechanics of Jumping and Tendon Strain 01:05:25 The Role of Foot Position in Athletic Performance 01:10:59 The Importance of Play in Child Development 01:21:36 Upcoming Seminars and Future Projects   Takeaways Kids are incredibly efficient in their movements. Fingers in rock climbing are as crucial as the Achilles tendon for runners. Climbing provides a fun way to train without expending willpower. Integrating fun into training can enhance performance and enjoyment. Seasonal training adjustments can help maintain athletic performance. Managing tendon health is essential to prevent injuries during training. Volume in training is more effective when it feels enjoyable. Isometric training is beneficial for both climbing and other athletic pursuits. Understanding the body's response to training is key to avoiding burnout. Finding natural movement patterns can lead to better strength outcomes. Training methods evolve over time, adapting to seasonal changes. Injuries often stem from timing issues in muscle activation. Incorporating music and metronomes can enhance training effectiveness. Flywheel training may offer unique benefits for tendon health. Finger tendons may develop differently compared to Achilles tendons. Personal experiences with injuries can inform training practices. Prehab strategies are essential for maintaining athletic health. Variability in training can lead to better movement quality. Simplicity in training can yield maximal benefits. Understanding biomechanics is crucial for effective rehabilitation. It's important to incorporate variability in training for better performance. Rehabilitation should be approached with a focus on play and enjoyment. Athletes often need to balance strength training with play to avoid injuries. Understanding the mechanics of jumping can help prevent tendon strain. Foot position can significantly impact athletic performance and injury risk. Free play is essential for developing strong tendons in children. Jump roping can enhance plyometric development in kids. Wrestling can be beneficial for children's physical development. Coaches need to manage workloads to prevent injuries in athletes. Training should be approached as a creative art form.    Notes here: https://jackedathlete.com/podcast-122-tendons-with-joel-smith/ Joel’s website: https://www.just-fly-sports.com Joel on Instagram: https://www.instagram.com/justflysports/?hl=en