Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Jayaseelan, Dhinakar J.; Mischke, John J; Strazzulla, Raymond L

doi:10.3390/jfmk4020034

Cited by 13 publications

(12 citation statements)

References 50 publications

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“…As such, it would be logical to suggest that these greater training loads and hence greater strain on the corresponding tendon may lead to greater or faster tendon adaptation compared to CON or conventional RET. It is perhaps for this reason that ECC protocols are often utilised for tendinopathies [11,25,32]. Unfortunately, less is known about the adaptability of healthy human tendon to ECC loading [56].…”

Section: Introductionmentioning

confidence: 99%

Muscle and tendon adaptations to moderate load eccentric vs. concentric resistance exercise in young and older males

et al. 2021

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Resistance exercise training (RET) is well-known to counteract negative age-related changes in both muscle and tendon tissue. Traditional RET consists of both concentric (CON) and eccentric (ECC) contractions; nevertheless, isolated ECC contractions are metabolically less demanding and, thus, may be more suitable for older populations. However, whether submaximal (60% 1RM) CON or ECC contractions differ in their effectiveness is relatively unknown. Further, whether the time course of muscle and tendon adaptations differs to the above is also unknown. Therefore, this study aimed to establish the time course of muscle and tendon adaptations to submaximal CON and ECC RET. Twenty healthy young (24.5 ± 5.1 years) and 17 older males (68.1 ± 2.4 years) were randomly allocated to either isolated CON or ECC RET which took place 3/week for 8 weeks. Tendon biomechanical properties, muscle architecture and maximal voluntary contraction were assessed every 2 weeks and quadriceps muscle volume every 4 weeks. Positive changes in tendon Young’s modulus were observed after 4 weeks in all groups after which adaptations in young males plateaued but continued to increase in older males, suggesting a dampened rate of adaptation with age. However, both CON and ECC resulted in similar overall changes in tendon Young’s modulus, in all groups. Muscle hypertrophy and strength increases were similar between CON and ECC in all groups. However, pennation angle increases were greater in CON, and fascicle length changes were greater in ECC. Notably, muscle and tendon adaptations appeared to occur in synergy, presumably to maintain the efficacy of the muscle–tendon unit.

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Section: Introductionmentioning

confidence: 99%

Muscle and tendon adaptations to moderate load eccentric vs. concentric resistance exercise in young and older males

et al. 2021

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“…However, the eccentric exercises could affect nervous system sensitization and enhance healthy tissue tolerance, rather than cause degeneration or dysfunctional tissue [ 45 ]. Yu et al [ 46 ] confirmed that eccentric is more effective than concentric strengthening for reducing pain and improving function in patients with Achilles tendinopathy. In a study by Stasinopoulos [ 16 ], an exercise program based on the Alfredson protocol was superior to the Stanish model, and Vanderplus et al [ 29 ] showed good results in a long-term follow-up study.…”

Section: Discussionmentioning

confidence: 99%

Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review

Pavone

Vescio

Mobilia

et al. 2019

JFMK

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Achilles tendinopathy is a common musculoskeletal disorder. Athletes, runners and jumpers, and the sedentary are frequently affected. Numerous are the therapeutic choices to manage these kinds of disorders. The aim of this review is to analyze the available literature to document the up-to-date evidence on conservative management of Achilles tendinopathy. A systematic review of two medical electronic databases was performed by three independent authors, using the following inclusion criteria: conservative treatment consisted of pharmacologic, physical therapy without operative treatment, with more of 6 months symptoms and a minimum average of 6-months follow-up. Studies of any level of evidence, reporting clinical results, and dealing with Achilles tendinopathy and conservative treatment were searched for. A total of n = 1228 articles were found. At the end of the first screening, following the previously described selection criteria, we selected n = 94 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 29 articles. Achilles tendinopathy is a frequent musculoskeletal disorder and several conservative treatments have been proposed, but no therapy is universally accepted, except for eccentric exercise training, which is the gold standard and a commonly used protocol.

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“…While the efficacy of eccentric muscle actions used as therapeutic interventions is often viewed through the lens of muscle adaptations, early applied work within this field involved the treatment of tendinopathies [ 7 , 36 ]. The mechanism of tendon tissue remodeling secondary to eccentric exercise includes the response of tenocytes to strain which results in adaptations such as increased collagen synthesis and normalized collagen morphology [ 36 , 37 ].…”

Section: Eccentric Exercise As a Therapeutic Interventionmentioning

confidence: 99%

Eccentric Exercise: Adaptations and Applications for Health and Performance

Harris‐Love

Gollie

Keogh

2021

JFMK

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The goals of this narrative review are to provide a brief overview of the muscle and tendon adaptations to eccentric resistance exercise and address the applications of this form of training to aid rehabilitative interventions and enhance sports performance. This work is centered on the author contributions to the Special Issue entitled “Eccentric Exercise: Adaptations and Applications for Health and Performance”. The major themes from the contributing authors include the need to place greater attention on eccentric exercise mode selection based on training goals and individual fitness level, optimal approaches to implementing eccentric resistance exercise for therapeutic purposes, factors that affect the use of eccentric exercise across the lifespan, and general recommendations to integrate eccentric exercise in athletic training regimens. The authors propose that movement velocity and the absorption or recovery of kinetic energy are critical components of eccentric exercise programming. Regarding the therapeutic use of eccentric resistance training, patient-level factors regarding condition severity, fitness level, and stage of rehabilitation should govern the plan of care. In athletic populations, use of eccentric exercise may improve movement competency and promote improved safety and performance of sport-specific tasks. Eccentric resistance training is a viable option for youth, young adults, and older adults when the exercise prescription appropriately addresses program goals, exercise tolerability, and compliance. Despite the benefits of eccentric exercise, several key questions remain unanswered regarding its application underscoring the need for further investigation.

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Eccentric Exercise for Achilles Tendinopathy: A Narrative Review and Clinical Decision-Making Considerations

Cited by 13 publications

References 50 publications

Muscle and tendon adaptations to moderate load eccentric vs. concentric resistance exercise in young and older males

Muscle and tendon adaptations to moderate load eccentric vs. concentric resistance exercise in young and older males

Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review

Eccentric Exercise: Adaptations and Applications for Health and Performance

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