👉 Complete the 30 Sec Survey & Find Your Best PHT Recovery Plan

🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉

For all other PHT resources, go to: https://proximalhamstringtendinopathy.info/

Tendon pain is often treated as a purely physical problem. Strengthen the tendon, adjust the load, and eventually things should improve.

But what happens when the pain persists for months… or even years?

In this episode, Brodie speaks with physiotherapist and PhD researcher Jack Mest about a recent systematic review and meta-analysis exploring the psychological profile of people with persistent tendinopathy. The research compared people with chronic tendon pain to healthy controls and uncovered something surprising: fear of movement wasn’t the main psychological factor.

Instead, the research found that pain catastrophizing — a negative outlook toward pain and recovery — appeared more common in people with persistent tendinopathy.

This episode explores how psychological factors may influence tendon pain, why lower limb injuries may carry a greater psychological burden, and why clinicians need to treat the person behind the injury — not just the tendon itself.

If you’re a runner struggling with Achilles pain, plantar fasciopathy, proximal hamstring tendinopathy, or another persistent tendon injury, this conversation will help you understand why recovery can feel so frustrating — and what might help.

In This Episode

Brodie and Jack discuss:

• Why tendinopathy often becomes a chronic condition
• What the biopsychosocial model means for tendon rehab
• The difference between kinesiophobia (fear of movement) and pain catastrophizing
• Why catastrophizing appears more common in persistent tendon pain
• Why lower limb tendinopathies may have greater psychological impact than upper limb injuries
• The role of beliefs, expectations, and past experiences in shaping pain
• Why clinicians should ask about patients’ thoughts and fears about their injury
• Whether psychological traits are pre-existing or develop after chronic pain begins
• Practical advice for runners dealing with long-term tendon pain

About the Guest

Jack Mest is a physiotherapist and PhD researcher whose work focuses on understanding why tendinopathy becomes chronic and how psychological factors influence tendon pain.

His research aims to improve the way clinicians approach tendon rehabilitation by integrating biological, psychological, and social factors into treatment.

Follow Jack's research and updates:
X (Twitter): @Mest_Jack
Facebook: Jack Mest Physio
Paper summary: https://www.jospt.org/do/10.2519/jospt.blog.2026017/full/

👉 Complete the 30 Sec Survey & Find Your Best PHT Recovery Plan

🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉

For all other PHT resources, go to: https://proximalhamstringtendinopathy.info/

In this episode, I sit down with Kirsten—Melbourne local, personal trainer, and someone who knows her way around the gym—yet still found herself stuck in a long and frustrating battle with proximal hamstring tendinopathy (PHT).

Like many runners and active individuals, Kirsten spent months going in circles. Despite doing all the “right” things—rest, isometrics, backing off training—her symptoms kept returning. Sitting became unbearable, training was inconsistent, and the mental toll started to build.

But everything changed when she shifted her approach.

This conversation dives into the exact turning point in her rehab—what worked, what didn’t, and the key mindset shifts that helped her go from constant pain… to full confidence in her training again.

Instagram mentions:

https://www.instagram.com/reels/DWHlIU8jffK/

https://www.instagram.com/itsdrglutes?igsh=aXZodW5wYzE5a2h0

https://www.instagram.com/nunzicoaching?igsh=bGFqdzZ1b2llZXZn

Podcast mention:

Tim Ferriss Show episode with Dr. Keith Baar (episode #797). The episode covers:

• Tendon loading and repair
• The "Anti-RICE Protocol" (i.e., don't rest — use load as an anti-inflammatory)
• Isometrics vs. eccentrics for tendon rehab
• Simple exercises that can repair tendons (tennis elbow, etc.)

👉 Complete the 30 Sec Survey & Find Your Best PHT Recovery Plan

🎉 Sign up for the FREE PHT 5-Day Course HERE 🎉

For all other PHT resources, go to: https://proximalhamstringtendinopathy.info/

Contact Dr. Alex Hardy and his team at Dr.hardy@chirurgiedusport.com

In this episode, Brodie is joined by hamstring surgeon Dr. Alex Hardy to break down exactly what to do before and after hamstring surgery. They cover the key differences between acute and chronic injuries, and what that means for your behaviour leading into surgery. For acute avulsions, the priority is speed—getting an MRI quickly and avoiding unnecessary delays—while keeping activity minimal. In contrast, chronic cases and tendinopathies benefit from staying active, maintaining strength and cardio, and avoiding unnecessary deconditioning.

A key takeaway: there’s very little you can do pre-surgery to “make things worse,” but there’s a lot you can do to set yourself up for a smoother recovery.

The conversation then shifts to post-operative rehab, where patience is critical. Dr. Hardy explains why the first 6 weeks are highly protective (often involving a brace and minimal hamstring loading), followed by a gradual return to movement, strength, and eventually running around the 3–4 month mark. They discuss exercise progressions (starting with closed-chain work, then progressing to open-chain and eccentric loading), common pitfalls like premature overload or slips during early recovery, and when to be concerned about symptoms like persistent pain or sciatic irritation.

If you’re considering surgery or currently navigating recovery, this episode gives you a clear, realistic roadmap—what matters most, what to avoid, and how to maximise your outcome