Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial
One page on PainSci cites van Ark 2016: Tennis Elbow Guide
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
OBJECTIVES: Many athletes with patellar tendinopathy participate in sports with symptoms during or after activities. Current treatments do not decrease pain in-season; eccentric exercises in-season result in an increase in pain. This study examined if isometric and isotonic exercises relieved pain in competing athletes with patellar tendinopathy.
DESIGN: Randomised clinical trial.
METHODS: Jumping athletes with patellar tendinopathy playing at least three times per week participated in this study. Athletes were randomised into an isometric or isotonic exercise group. The exercise programs consisted of four isometric or isotonic exercise sessions per week for four weeks. Pain during a single leg decline squat (SLDS) on a Numeric Rating Scale (NRS; 0-10) was used as the main outcome measure; measurements were completed at baseline and at 4-week follow-up.
RESULTS: Twenty-nine athletes were included in this study. Median pain scores improved significantly over the 4-week intervention period in both the isometric group (Z=-2.527, p=0.012, r=-0.63) and isotonic group (Z=-2.952, p=0.003, r=-0.63). There was no significant difference in NRS pain score change (U=29.0, p=0.208, r=0.29) between the isometric group (median (IQR), 2.5 (1-4.5)) and isotonic group (median (IQR), 3.0 (2-6)).
CONCLUSIONS: This is the first study to show a decrease in patellar tendon pain without a modification of training and competition load and the first study to investigate isometric exercises in a clinical setting. Both isometric and isotonic exercise programs are easy-to-use exercises that can reduce pain from patellar tendinopathy for athletes in-season.
related content
- “The pain of tendinopathy: physiological or pathophysiological?,” Rio et al, Sports Medicine, 2014.
- “Isometric exercise induces analgesia and reduces inhibition in patellar tendinopathy,” Rio et al, British Journal of Sports Medicine, 2015.
- “Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial,” Rio et al, Clinical Journal of Sports Medicine, 2017.
- “The Acute Effect of Isometric Versus Isotonic Resistance Exercise in Patients With Patellar Tendinopathy—does contraction type matter? A randomised crossover trial,” Holden et al, {Presented at the Scandinavian Sports Medicine Conference, Copenhagen, Denmark, 2019}, 2019.
Specifically regarding van Ark 2016:
- “Isometric exercise for acute pain relief: is it relevant in tendinopathy management?,” Silbernagel et al, British Journal of Sports Medicine, 2019.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Classical Conditioning Fails to Elicit Allodynia in an Experimental Study with Healthy Humans. Madden 2017 Pain Med.
- Topical glyceryl trinitrate (GTN) and eccentric exercises in the treatment of mid-portion achilles tendinopathy (the NEAT trial): a randomised double-blind placebo-controlled trial. Kirwan 2024 Br J Sports Med.
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- Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes. Aasdahl 2021 BMC Musculoskelet Disord.
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.