Why do tendon researchers overlook the patient's psychological state? The review with no papers.

Abstract

Exercise or loading interventions remain the conservative treatment of choice in the management of tendinopathy.1 However, as many as 60% of individuals experience continued symptoms, while up to a quarter of patients experiencing symptoms 10 years after treatment.2 What might explain these rather sobering outcomes? We opine that given the complex and often persistent nature of tendinopathy, addressing other factors in addition to exercise variables may prove beneficial. We focus here on the potential role of psychological factors. Psychological factors have been implicated in many other musculoskeletal disorders, either as prognostic factors,3 as treatment effect modifiers4 or as mediators of recovery.5 As tendinopathy has been shown to be associated with psychological distress and poor quality of life,6 7 measuring psychological factors in randomised controlled trials (RCTs) of exercise would appear justifiable. This does not mean outcomes will necessarily improve, but the evidence from other musculoskeletal disorders suggests that there is merit to understanding the potential implications of psychological factors on prognosis, treatment effect modification