Eccentric exercises; why do they work, what are the problems and how can we improve them?
Three articles on PainSci cite Rees 2009: 1. Complete Guide to Plantar Fasciitis 2. Eccentric Contraction 3. Achilles Tendinitis Treatment Science
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.
Eccentric exercises (EE) have proved successful in the management of chronic tendinopathy, particularly of the Achilles and patellar tendons, where they have been shown to be effective in controlled trials. However, numerous questions regarding EE remain. The standard protocols are time-consuming and require very motivated patients. EE are effective in some tendinopathies but not others. Furthermore, the location of the lesion can have a profound effect on efficacy; for example, standard EE in insertional lesions of the Achilles are ineffective. Until recently little was known of the effect of EE on tendinopathic tendons, although a greater understanding of this process is emerging. Additionally, recent in vivo evidence directly comparing eccentric and concentric exercises provides a possible explanation for the therapeutic benefit of EE. The challenge now is to make EE more effective. Suggestions on areas of future research are made.
related content
- “Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols,” Carl M Askling, Magnus Tengvar, and Alf Thorstensson, British Journal of Sports Medicine, 2013.
- “Acute hamstring injuries in Swedish elite sprinters and jumpers: a prospective randomised controlled clinical trial comparing two rehabilitation protocols,” Carl M Askling, Magnus Tengvar, Olga Tarassova, and Alf Thorstensson, British Journal of Sports Medicine, 2014.
- “Efficacy of eccentric exercise in lower limb tendinopathies in athletes,” Antonio Frizziero, Filippo Vittadini, Augusto Fusco, Arrigo Giombini, and Stefano Masiero, J Sports Med Phys Fitness, 2016.
- “Do structural changes (eg, collagen/matrix) explain the response to therapeutic exercises in tendinopathy: a systematic review,” Benjamin T Drew, Toby O Smith, Chris Littlewood, and Ben Sturrock, British Journal of Sports Medicine, 2014.
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:
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.
- No effect of creatine monohydrate supplementation on inflammatory and cartilage degradation biomarkers in individuals with knee osteoarthritis. Cornish 2018 Nutr Res.
- The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Bebee 2021 Med J Aust.
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.