The Tendon Rehabilitation Lab is committed to improving care for people with tendon injury and dysfunction. Our research is aimed at advancing our understanding of person-specific factors that affect a tendon’s ability to respond to treatment. This includes local factors, like tendon structure, and systemic factors, like the presence of diabetes.

Tendons connect muscles to bone and are critical for transferring muscle forces into efficient movement. One of the best available treatments for tendon injury is to gradually increase the loads placed on the tendon so that the tendon receives the signals needed to heal. While progressive tendon loading is the recommended standard of care, there is a need to further clinical decision-making and improve treatment options for people with tendon dysfunction. Optimizing care is important because tendon recovery regularly takes months, recurrent injury is common, and response to tendon loading varies from person to person.

The Tendon Rehabilitation Lab’s vision is to optimize treatment for tendon dysfunction by personalizing dosing of tendon loading and aligning adjunctive treatments to give the tendon the environment and signals it needs to recover. Our approach to answer these tendon questions combines clinical performance measures, diagnostic imaging, and basic science methods.

Faculty Investigators

Jennifer A. Zellers, PT, DPT, PhD

Trainees and Staff Members

Rachana Vaidya, PhD
Postdoctoral Research Associate

Reika McNish
Research Assistant

Current Projects

Effect of Diabetes and Advanced Glycation End-products (AGEs) Accumulation on Achilles Tendon Structure

Quantitative Polarized Light Imaging during tensile mechanical testing of a tendon.

Eighty percent of people attending outpatient physical therapy have diabetes, pre-diabetes, or diabetes risk factors. People with diabetes are at 3x greater risk for developing tendon injury. Despite the clinical implications of diabetes on tendon tissue, relatively little is known about how diabetes affects tendon health and recovery from injury. In this study, we are examining the effect of accumulation of AGEs (biproducts of a hyperglycemic environment) on tendon tissue. This study incorporates a variety of basic science tools for tendon assessment, including tensile mechanical testing, Quantitative Polarized Light Imaging, and biochemical assays, in collaboration with labs in Mechanical Engineering & Materials Science and the Department of Orthopaedics.

Application of Quantitative Magnetic Resonance Imaging to Characterize Tendon Tissue

Quantitative MRI has been used to characterize a variety of orthopaedic tissues, but its application in tendon has been limited due to technical challenges.

Heel-rise assessment for strength performance.

Recent advances in MRI sequences along with strategic patient positioning have allowed for MRI to be used to assess tendon tissue. This project aims to improve our understanding of the physiological implications of quantitative MRI metrics by comparing them to measures of tendon structure in ex vivo tendon specimens. Further, we are investigating reliability of these measures and their relationship to strength testing performance in patients. This project is in collaboration with the Mallinckrodt Institute of Radiology.

Funding: NIH F32 DK123916 (PI: Zellers)

Diffusion tensor imaging fiber tracking of two tendon specimens.