Eccentric exercises work a muscle when it is lengthening, not contracting or shortening. These exercises are often included in the rehabilitation of tendon injuries like tendinitis to help regain normal tendon function and prevent future injuries. However, when eccentric exercises are performed inappropriately, you may increase your risk of injury, especially to your muscles and tendons. Consult a personal trainer or physical therapist for an appropriate exercise or rehabilitation program.
Tendinopathy
A tendon connects muscle to bone. Tendon pathology is the disease or injury of your tendon and is also referred to as tendinopathy. Most tendon injuries are chronic or overuse injuries, resulting in prolonged inflammation and pain. Inflammation of your tendon or its surrounding sheath may also be called tendinitis or tenosynovitis, respectively. Injury and degeneration also decreases tendon strength, making it more susceptible to a strain or tear.
Eccentric Exercises
Eccentric exercises load or work your muscles and tendons while they are lengthening. They include downhill running, squats on a decline board, step-downs, stiff leg deadlift and Nordic hamstring. Nordic hamstring is performed kneeling on the floor. Slowly lower your chest to the floor until you are in a push-up position on your hands and knees. Other exercises include both eccentric and concentric contractions. Concentric contraction is the loading of your muscles while they are shortening. For example, calf raises on a step involve concentric contraction when you raise your heels up and eccentric contraction when you lower your heels down.
Benefits
A 2011 article in "The International Journal of Sports Physical Therapy" reported that tendons have oxygen consumption that is seven and a half times lower than that of muscles. Eccentric exercises require less oxygen and energy compared to concentric exercises and are therefore less strenuous on tendons, especially during rehabilitation. Eccentric exercises appear to decrease pain, increase tendon strength and reduce thickening of your tendon, which is common after tendon injuries. A rehabilitation program involving eccentric exercises may decrease pain and improve strength in as early as 10 weeks and results may last up to 32 months following a tendon injury.
Additional Considerations
There is still some debate on how eccentric exercises effect tendinopathies and whether eccentric exercises are more beneficial than other exercises like stretches and concentric exercises, both in the short term and long term. Although eccentric exercises appear to be an important part in tendon rehabilitation and long-term injury prevention, rest, ice, non-steroidal anti-inflammatory drugs or NSAIDS, stretching and concentric exercises may be equally as important. Furthermore, eccentric exercises may lead to more pain and injury if performed too soon, progress too quickly or are performed using poor technique.
References
- "The International Journal of Sports Physical Therapy"; The Role and Implementation of Eccentric in Athletic Rehabilitation: Tendinopathy, Hamstring Strains, and ACL Reconstruction; Daniel Lorenz, D.P.T., et al.; March 2011
- "Rheumatology"; The Mechanism for Efficacy of Eccentric Loading in Achilles Tendon Injury; An in vivo Study in Humans; J. D. Rees, et al.; 2008
- "Journal of Athletic Training"; Does Eccentric Exercise Reduce Pain and Improve Strength in Physically Active Adults With Symptomatic Lower Extremity Tendinosis? A Systematic Review; Noah J. Wasielewski, P.h.D., et al. ; 2007
- "British Journal of Sports Medicine"; The Evolution of Eccentric Training as Treatment for Patellar Tendinopathy (Jumper's Knee): A Critical Review of Exercise Programmes; Ha °vard Visnes, et al.; 2007
- "British Journal of Sports Medicine"; Chronic Tendinopathy: Effectiveness of Eccentric Exercise; Brett L Woodley, et al.; 2007
- "Physical Therapy"; Evidence in Practice; Alon Rabin, P.T.; March 2006
