The Hidden Psychological Factors Behind Persistent Tendon Pain with Jack Mest

·36 min·2 clips

The evidence did not show a kinesiophobia difference between tendinopathy groups.

1. The Run Smarter Podcast episode examines Jack Mest's review on psychological factors in persistent tendinopathy. 2. Brodie hosts the discussion, and Jack Mest joins as a sports and exercise physio and PhD candidate working on tendon-pain research. 3. The episode asks what psychological profile appears in people with tendinopathy and why that matters for rehab. 4. Jack says his research group in Canberra is interested in why tendon pain becomes chronic and why long-term disability is common. 5. He connects the project to the biopsychosocial model of care used in chronic low back pain and knee osteoarthritis. 6. He says tendinopathy research has focused more on physical outcomes than on psychological factors such as anxiety, depression, and pain-related fear. 7. The review defined persistent pain as pain lasting more than three months, using the World Health Organization chronic pain definition. 8. The team included tendinopathy sites recognized by the ICON group, including gluteal, proximal hamstring, patellar, Achilles, plantar fasciopathy, tibialis posterior, rotator cuff related shoulder pain, and lateral elbow tendinopathy. 9. Jack explains that psychological factors were grouped into emotional factors, cognitive factors, and behavioral factors such as fear avoidance. 10. He gives pain self-efficacy as an example of a person’s evaluation of whether they can complete a task safely despite pain. 11. Jack expected fear of movement to be part of the tendinopathy profile because tendons are loaded through movement and because fear-avoidance is well known in chronic low back pain. 12. The review instead found that kinesiophobia was not different between groups, while pain catastrophizing was higher in the tendinopathy group. 13. Jack distinguishes catastrophizing from exaggerating pain and defines it as a negative mental set with rumination, magnification, and helplessness. 14. He contrasts catastrophizing with a fear-based presentation, such as avoiding running intervals because of a belief that Achilles pain will rupture. 15. The synthesis also found more anxiety, depression, and poorer mental health in lower-limb tendinopathy, but not in upper-limb tendinopathy. 16. Jack says upper-limb injuries may allow more escape from pain because one arm can be avoided more easily than one leg during walking. 17. He notes that general self-efficacy, neuroticism, and extraversion did not differ in the studies they synthesized. 18. The conversation stays interview-based and clinically focused, with Brodie testing definitions through examples from Achilles and proximal hamstring cases. 19. Runners with persistent tendon pain who want a biopsychosocial explanation for their symptoms. 20. Listeners wanting a purely tissue-focused sports rehab discussion.

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