On this episode of the Healthy Wealthy and Smart Podcast, I had the pleasure of welcoming Dr. Ebonie Rio onto the show to discuss tendinopathy. Ebonie is a physiotherapist and researcher with extensive experience in tendon pain. She is a post doctoral researcher at La Trobe University, and completed her PhD in tendon pain, researching “Corticospinal responses associated with patellar tendinopathy and the effect of externally paced strength training.” Her research has changed rehabilitation practise around the world. In this episode, we discuss: -Tendon Neuroplastic Training -Motor cortex changes with tendon pain and the powerful role a metronome can play for your brain excitability -How to utilize time under tension and load to reduce tendon pain -The importance of patient input for goal setting -And so much more!   Ebonie suggests, “We are not winning the battle with musculoskeletal pain. It is so common.” Physiotherapists need to be aware of and utilize the best evidence available to treat the growing problem of musculoskeletal pain. Ebonie believes a skillful examination and evaluation can guide differential diagnosis and she stresses, “It’s critical that our rehab, as we go forward, becomes much more tailored to what we are seeing in front of us.”   Ebonie is a proponent of utilizing isometric exercise in addition to other adjunctive therapies to reduce pain and develop adherence into a loading program. She suggests, “When you see someone with pain, we need a way in. And as physios, we’ve got some really great tools.” Ultimately, to treat tendon pain, the research evidence supports that, “Load is our primary modality.”   Manual skills have a role in the examination but from Ebonie’s perspective the information specifically from palpation is more limited. She outlines, “The problem with palpation is that it is nonspecific. Lots of things are going to hurt to poke.” Due to the nonspecific nature, Ebonie has found that, “Our hands are incredibly important; poking is just not that useful when it comes to diagnosis.”   For more information on Dr. Ebonie Rio: Ebonie is a physiotherapist and researcher with extensive experience in tendon pain. She is a post doctoral researcher at La Trobe University, and completed her PhD in tendon pain, researching “Corticospinal responses associated with patellar tendinopathy and the effect of externally paced strength training.” Her research has changed rehabilitation practise around the world. She currently is involved in a variety of projects investigating tendon pain, especially in the lower limb, however also other areas such as investigating innovative new rehabilitation techniques. Ebonie also still consults clinically, having been previously involved at the Australian Institute of Sport, Australian Ballet, and Winter Olympics.   Resources discussed on this show: Leung et al 2015: Motor cortex excitability is not differentially modulated following skill and strength training. Professor Jill Cook Email: e.rio@latrobe.edu.au La Trobe Sport and Exercise Medicine Centre   Thanks for listening and subscribing to the podcast! Make sure to connect with me on twitter, instagram and facebook to stay updated on all of the latest! Show your support for the show by leaving a rating and review on iTunes!   Have a great week and stay Healthy Wealthy and Smart!   Xo Karen