Silbernagel et. al. have provided a clinically relevant study that deals with not only symptomatic recovery of tendon injuries, but functional recovery as well. The results show that of the 67% of patients who achieved symptomatic recovery only 25% had achieved acceptable level of muscle function.

When symptoms abate, patients are likely to stop therapy and go back to normal activities. Unless educated that symptoms can abate before functional recovery ensues, the patient can wrongly assume that their injury has healed fully. If the patient returns to an activity that exceeds the tissue capabilities, the injury cycle is re-visited. By assessing the patient with a clinically relevant questionnaire and functional testing, the clinician has a valuable tool readily accessible to ensure full recovery.

Patients must be reminded that the tissue is still injured and must go through the healing process to recover full function. It also underscores the importance of setting functional baselines and functional goals that are meaningful to the patient, allowing them to judge progress and provide a realistic end-point. This study fits into MDT philosophy for two reasons; It provides the framework for the clinician to develop an optimal treatment plan for the patient, and it equips the patient with the tools necessary for self-assessment.

Therapists trained in Mechanical Diagnosis and Therapy are well equipped to handle such patients, as they are skilled at establishing meaningful baselines, progressing forces, re-assessing status and educating the patient. Most importantly MDT emphasizes both recovery of function and self-assessment to ensure that the patient is not only safe during formal therapy, but he/she is prepared to leave therapy with the appropriate tools to avoid re-injury.

Extremities: Anatomical, physiological, and pain studies