Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial
Two articles on PainSci cite Rio 2017: 1. Tennis Elbow Guide 2. 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.
OBJECTIVE: This study aimed to compare the immediate analgesic effects of 2 resistance programs in in-season athletes with patellar tendinopathy (PT). Resistance training is noninvasive, a principle stimulus for corticospinal and neuromuscular adaptation, and may be analgesic.
DESIGN: Within-season randomized clinical trial. Data analysis was conducted blinded to group.
SETTING: Subelite volleyball and basketball competitions.
PARTICIPANTS: Twenty jumping athletes aged more than 16 years, participating in games/trainings 3 times per week with clinically diagnosed PT.
INTERVENTIONS: Two quadriceps resistance protocols were compared; (1) isometric leg extension holds at 60 degrees knee flexion (80% of their maximal voluntary isometric contraction) or (2) isotonic leg extension (at 80% of their 8 repetition maximum) 4 times per week for 4 weeks. Time under load and rest between sets was matched between groups.
MAIN OUTCOME MEASURES: (1) Pain (0-10 numerical rating score) during single leg decline squat (SLDS), measured preintervention and postintervention sessions. (2) VISA-P, a questionnaire about tendon pain and function, completed at baseline and after 4 weeks.
RESULTS: Twenty athletes with PT (18 men, mean 22.5 ± 4.7 years) participated (isotonic n = 10, isometric n = 10). Baseline median SLDS pain was 5/10 for both groups (isotonic range 1-8, isometric range 2-8). Isometric contractions produced significantly greater immediate analgesia (P < 0.002). Week one analgesic response positively correlated with improvements in VISA-P at 4 weeks (r = 0.64).
CONCLUSIONS: Both protocols appear efficacious for in-season athletes to reduce pain, however, isometric contractions demonstrated significantly greater immediate analgesia throughout the 4-week trial. Greater analgesia may increase the ability to load or perform.
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.
- “Do isometric and isotonic exercise programs reduce pain in athletes with patellar tendinopathy in-season? A randomised clinical trial,” van Ark et al, Journal of Science & Medicine in Sport, 2016.
- “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 Rio 2017:
- “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:
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