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175. Tendinopathy treatment: Your guide to isometrics, isotonics & plyometrics with Dr Ebonie Rio

Release Date: 02/18/2026

175. Tendinopathy treatment: Your guide to isometrics, isotonics & plyometrics with Dr Ebonie Rio

Physio Edge podcast

Should you prescribe isometric or isotonic exercises for your patient's lower limb tendinopathy? When is it safe to add plyometric loading, and how do you progress running or jumping without flaring your patients tendon pain? Why do some "tricky tendons" refuse to respond to your best loading programs? Dr Ebonie Rio (Post-Doctoral Senior Research Fellow, La Trobe University) reveals the evidence-based answers as she guides you through the clinical reasoning and practical strategies for managing patellar, achilles, and other lower limb tendinopathies. In this conversation, you'll follow...

174. ACJ - The hidden culprit behind stubborn shoulder pain? Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Have any of your shoulder patients improved and then plateaued, unable to regain their full range of movement, or get rid of their painful arc? Sometimes it’s not the cuff, capsule, nerves or neck—it’s the acromioclavicular joint (ACJ) holding things back. In this episode, Jo Gibson sheds light on this often-overlooked contributor to persistent shoulder pain. From real patient case studies to the latest research and simple clinic-ready symptom modification tests, Jo shares practical strategies you can use immediately. Learn how to identify ACJ involvement, and use targeted rehab...

173. Hip flexor pain in runners: Diagnosis, myths, and rehab. Physio Edge Track record: Running repairs podcast with Tom Goom

Physio Edge podcast

Anterior hip pain is often blamed on the hip flexors, but in runners, that’s rarely the diagnosis. So how can you identify the real cause and guide patients to a safe, effective recovery? In this episode, Tom Goom (Running Physio) explores the function of the hip flexors in running, key differentials for anterior hip or groin pain, and practical rehab strategies you can use right away. You’ll discover: Why true hip flexor tendinopathy is uncommon in endurance runners Red flags and key tests to identify bone stress fractures and intra‑articular pathology Early‑stage loading strategies...

172. Shoulder pain assessment & clinical reasoning. Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Your patient presents with shoulder pain, and straight away you need to identify: Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is the pain actually coming from the shoulder? Could it be the cervical spine? Is there a tear that needs urgent referral? Should you order imaging? Refer to a surgeon? Or confidently continue with rehab? In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple,...

171. Achilles tendon ruptures: Rehab & recovery with Prof. Peter Malliaras

Physio Edge podcast

Your patient is running, playing sport, or jumping or lunging forward - an activity with fast eccentric or concentric activity in dorsiflexion,and suddenly they feel like they’ve been kicked in the back of the leg. They might hear a snap and have difficulty weightbearing, walking and pushing off. What’s your likely diagnosis? You picked it - an Achilles tendon (AT) rupture. AT ruptures are a devastating injury that can drastically impact a patient’s ability to walk, run, or return to sport. Despite their frequency, there’s a lot of uncertainty among clinicians, patients, and even...

170. Brazilian Jiu Jitsu (BJJ) injuries with Dr Lachlan Giles

Physio Edge podcast

Brazilian Jiu-Jitsu (BJJ) is a popular grappling-based martial art that uses joint locks and chokes to subdue or submit opponents. It’s an intense, physically demanding sport with complex movements and submission techniques that involve a risk of injury, particularly to the knees, shoulders, elbows, neck, and lower back. It’s important for Physiotherapists and health professionals who treat BJJ athletes to understand the different mechanisms of injury, movements and positions athletes need to be able to perform, so they can develop successful rehabilitation programs, and safely and...

169. Beyond stretching: How to create lasting flexibility. Physio Edge Running repairs podcast with Tom Goom

Physio Edge podcast

Static stretching has long been used to improve flexibility, but research shows its effects are often short-lived. So how can you help patients achieve lasting improvements? In this episode, Tom Goom (Running Physio) explores exercises you can provide to patients to increase muscle fascicle length, improve flexibility, and reduce injury risk. You’ll discover: Why static stretching alone may not create long-term flexibility gains Exercises to improve muscle length and function Key training parameters for effective flexibility training Strategies to maintain flexibility improvements...

168. How to explain shoulder pain to patients. Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

How do the terms we use influence a patient’s understanding of their shoulder pain, their recovery expectations, and even their treatment choices? In this episode of the Physio Edge Shoulder Success Podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio), explores the power of language in physiotherapy and how our explanations can either support or hinder a patient’s progress. Drawing on research and real-world clinical experience, Jo discusses a compelling case study: Persistent shoulder pain after multiple treatments – A patient with years of ongoing pain, failed...

167. Bones, them strong bones: How to use bone loading programs. Physio Edge Running repairs podcast with Tom Goom

Physio Edge podcast

Bone strength and density are vital in your running and sporting patients who can experience bone stress injuries (BSI’s), and also as patients get older and more vulnerable to falls and fractures. How can you improve bone strength in patients following a bone stress injury such as Medial Tibial Stress Syndrome or stress fractures, or in other patients that you’d like to improve bone density or strength? Traditional approaches to strength and conditioning may not always address the needs of your patients recovering from bone stress injuries. That’s where bone loading programs come...

166. To tape or not to tape? Physio Edge Shoulder Success podcast with Jo Gibson

Physio Edge podcast

Taping: does it really help patients with shoulder pain, or is it just a brightly coloured placebo? In this thought-provoking episode of the Physio Edge Shoulder Success Podcast, Jo Gibson, upper limb rehab specialist at Rehab for Performance, unpacks the complexities of taping in shoulder rehabilitation. Drawing from the latest evidence and her extensive experience with shoulder pain, Jo shares two compelling case studies and whether taping was useful in the treatment of: Volleyball player post-stabilisation surgery – Despite passing all return-to-play criteria, this patient struggled...

More Episodes

Should you prescribe isometric or isotonic exercises for your patient's lower limb tendinopathy?

When is it safe to add plyometric loading, and how do you progress running or jumping without flaring your patients tendon pain?

Why do some "tricky tendons" refuse to respond to your best loading programs?

Dr Ebonie Rio (Post-Doctoral Senior Research Fellow, La Trobe University) reveals the evidence-based answers as she guides you through the clinical reasoning and practical strategies for managing patellar, achilles, and other lower limb tendinopathies.

In this conversation, you'll follow clinical examples and unpack the latest research to help you feel confident with tendinopathy assessment and treatment.

Inside this podcast you'll explore:

Tendon pathology explained: What’s happening inside tendinopathic tendons, how to explain tendinopathy and ultrasound scan results to patients
The role of isometrics: Whether isometrics actually change tendon structure, when to use isometrics to improve pain, optimal dosage, and whether isometrics are all your tendinopathy patients need
Safe loading from day one: When are both isometrics AND isotonics safe to start immediately, and how to choose isometric positions and loads.
The 24-hour emoji rule: How to teach patients to monitor their response after running or loading using the emoji system
What NOT to do: Exercises, manual therapy and supplements that won’t help tendon pain and may stir it up
Differential diagnosis mastery: How to distinguish patellar tendinopathy from patellofemoral pain, mid-portion achilles tendinopathy from peritendinitis, and when you've got the diagnosis wrong
Stairs as a progression exercise: The quasi-isometric stair protocol that works for everyone from sedentary patients to elite sprinters—and how to use tempo to control tendon load
Criteria-based progressions: Moving beyond time-based rehab to functional milestones
When loading programs fail: What to do when your patient is worse with your exercises

You'll walk away with:

Clear clinical reasoning to differentiate true tendinopathy from other conditions
Practical loading frameworks that progress your isometrics, isotonics and plyometrics based on patient response
Patient education scripts that use imaging findings to build confidence rather than fear
Simple monitoring tools (the emoji system) to empower patients to self-manage their load progression

Dr Ebonie Rio is a post doc researcher at La Trobe University and has completed her PhD in tendon pain, Masters Sports Phys, B. Phys (Hons) and B. App Sci. Her clinical career has included the Australian Institute of Sport, Australian Ballet Company, Australian Ballet School, Melbourne Heart Football Club, Alphington Sports Medicine Centre, Victorian Institute of Sport, 2006 Commonwealth Games, 2010 Vancouver Winter Olympics, 2010 Singapore Youth Olympics, 2012 London Paralympics, 18 months travelling with Disney's The Lion King stage show (Melbourne and Shanghai tour).

Get free access to the "Tricky tendons" infographic series

Unlock the secrets of successful tendinopathy assessment and treatment with this free infographic series for therapists.

Chapters:

00:02:57 - How isometrics emerged as a tendinopathy treatment
00:07:00 - How loading helps a tendon
00:07:38 - Tendon structure & how to describe tendinopathy to patients
00:12:27 - When and why tendinopathy develops
00:15:17 - Tendon imaging
00:17:38 - Differential diagnosis - Achilles peritendinitis vs mid-portion tendinopathy
00:19:35 - Does treatment change tendon structure?
00:21:27 - Can we load disorganised areas of tendon?
00:22:46 - Do supplements help?
00:24:44 - Avoid these in your tendinopathy treatment
00:26:47 - Finding the right level of running or load
00:28:40 - What causes tendinopathy to develop
00:31:52 - When and how to include isometrics in treatment
00:36:42 - When isometrics are likely to help or not help
00:38:51 - Choosing the starting position for isometrics
00:39:38 - How to describe isometrics to patients
00:40:23 - How to choose the load for isometrics
00:42:53 - When to include isotonics in treatment
00:44:03 - Plyometric & Stair loading
00:46:49 - How long should isometric holds be?
00:47:26 - Patient advice & discussion

Get free access to the "Tricky tendons" infographic series

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