Overcoming Proximal Hamstring Tendinopathy

The Hidden Psychological Factors Behind Persistent Tendon Pain with Jack Mest

April 21, 2026·35 min
Episode Description from the Publisher

👉 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 EpisodeBrodie and Jack discuss:Why tendinopathy often becomes a chronic conditionWhat the biopsychosocial model means for tendon rehabThe difference between kinesiophobia (fear of movement) and pain catastrophizingWhy catastrophizing appears more common in persistent tendon painWhy lower limb tendinopathies may have greater psychological impact than upper limb injuriesThe role of beliefs, expectations, and past experiences in shaping painWhy clinicians should ask about patients’ thoughts and fears about their injuryWhether psychological traits are pre-existing or develop after chronic pain beginsPractical advice for runners dealing with long-term tendon painAbout the GuestJack 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_JackFacebook: Jack Mest PhysioPaper summary: https://www.jospt.org/do/10.2519/jospt.blog.2026017/full/

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