Ep 43 Pt. II | Dr. Trent Salo: Tendon Health

Okay, so we've covered structure, we've covered mechanical properties.

Let's talk about that third domain you mentioned, which is symptoms and personal factors.

How does that influence tendon health?

I say that the, I've learned that the Achilles tendon is a litmus test for your overall health and a lot of good literature coming out supporting your metabolic health.

So the diabetes, the obesity, the hypercholesterolemia, hyperlipidemia, hypertension, all of those can impact your tendon.

And why that is, it's essentially creating this inflammatory state or systemic inflammatory state.

that then can impact the recovery of a tendon and so oftentimes in the athletic population we see entry into this tendinopathic loop via overload mechanical overload but especially being in the private sector now i've seen you know a few more general pop clients where a lot of them have you know have some of these metabolic issues or they have ankylosing spondylitis or rheumatoid arthritis or gout or some of these other systemic inflammatory conditions that impact their tendons.

Why does that matter? Well, you can't just give somebody heel raises and not worry about the rest if the primary reason they're having some of these tendon issues is more systemic, inflammatory, metabolic related than a mechanical overload related.

So yeah, that's sort of the fourth one.

Again, depending on the cohort or population you work in, you may not see a lot of these, but I do think it's important to keep in mind, especially in, you know, there's one example in sport where we had a D1 volleyball player who had insertional tendon pain bilaterally and ended up being positive for HLA-B27, which is just, again, an inflammatory marker that can cause some issues at the thesis or insertion.

So again, not look for elephants, not zebras or whatever the saying is, but it's important for, I think, everybody to understand that there can be tendon issues from more of like a metabolic entry point.

That's fascinating because I'm sure at some point you got pretty granular with tendon, tendon health, but all of a sudden it allowed you to zoom out with even a clearer picture.

You said an Achilles tendon is a good litmus test for overall health.

I mean, I think most practitioners, most general population people would never think, hey, how is this related to anything else going on in my body? I just have pain right here.

Yep.

So I work pretty closely with a physician here, a medical doctor.

We order blood work, or he does, I can't, but he orders blood work for a lot of the clients that come in that we suspect some type of inflammatory disorder.

And so, again, we've learned a lot of this from rheumatologists from overseas.

Paul Kerwin is a really good one.

He's got a really cool analogy or acronym called SCREENDOM, which is just like skin, colitis, or Crohn's, relatives, eyes.

early morning stiffness, nails, and a few others.

I can't remember off the top of my head.

But anyways, basically some of these things that you should look for in somebody that is presenting with something that just doesn't seem right.

Wow.

Yeah, that's really cool.