One theory is that this type of technique places load on the Achilles and helps the tendon adapt to the everyday strains that travel through it. Another hypothesis is that eccentrics exercises alter the stiffness or flexibility of the tendon, which in turn helps to relieve pain.
Why do eccentrics work for Achilles tendonitis?
Sep 16, 2015 · Improved strength and coordination through eccentric exercise also appears to coordinate and smooth muscle contractions in the calf thereby decreased asymmetrical loading patterns on the tendon. In short, eccentric exercise remains a staple in the conservative Physical Therapy management of Achilles tendinopathy but the reasons on its’ effectiveness continue …
Can eccentric exercises help with tendinopathy?
While tendinopathy often occurs in those who are active, it can occur in those who are inactive. Research has shown that an eccentric exercise program can be effective in the treatment of tendinopathies. The earliest studied was the Achilles tendon, and subsequent studies have shown benefits using eccentric exercises on other body regions including the patellar tendon, …
What are the benefits of eccentric exercises?
Oct 25, 2021 · One theory is that this type of technique places load on the Achilles and helps the tendon adapt to the everyday strains that travel through it. Another hypothesis is that eccentrics exercises alter the stiffness or flexibility of the tendon, which in turn helps to relieve pain.
Can stretches help with Achilles tendonitis?
Why Are Eccentric Exercises Effective? Stanish et al. suggested that eccentric exercises expose the tendon to a greater load than concentric exercises and proposed an eccentric exercise program as the best mechanism for strengthening the tendon. Alfredson originally hypothesized that eccentric exercises may cause changes in the metabolism of the tendon, which therefore …
Why do eccentric exercises help tendons?
The lowering phase is an eccentric contraction. Eccentric exercises have been designed to strengthen the tendon and non-contracting muscles. The proven effect of this is that it helps swollen tendons return to normal, thereby alleviating tendonitis.Nov 5, 2019
Why are eccentric exercises effective for Achilles tendinopathy?
The most commonly suggested mechanism through which eccentric exercises are believed to have an effect is the application of increased loads to the tendon stimulating structural tendon changes.
Are eccentric exercises effective for the treatment of Achilles tendinopathy?
There is some evidence that eccentric strengthening programmes may be effective in the management of tendinopathy of the main body of the Achilles tendon [15, 16]. Graded eccentric exercises regimen was proven to be effective in case–control studies and in prospective randomized control trials [15–19]. Stanish et al.
What is eccentric strengthening Achilles?
The programme to treat Achilles pain is designed to eccentrically load or stretch the tendon. In medical studies worldwide, this programme has been shown to provide excellent pain and symptom relief in many patients avoiding the need for surgery later on.
What are eccentric strengthening exercises?
Eccentric contraction exercises are an important and often overlooked component of strength training. Eccentric strength refers to tension being applied to a muscle as it lengthens. This is also when the muscle's force-producing capacity is most optimal.Aug 31, 2018
Are eccentric exercises good for tendons?
Eccentric exercise has been shown in the literature to be quite effective for certain types of tendon injuries. An “eccentric” movement is one that lengthens a muscle/tendon while under tension. An example would be the lowering phase of a push-up.
Why is eccentric loading important?
Athletes of any sport can benefit by using eccentric loading techniques in their traditional strength training programs. Eccentric training, which has been underused and undervalued, produces and improves factors that affect strength, power, running economy, and injury prevention.
Why is eccentric loading good?
It has also been shown that in addition to decreasing pain, isolated eccentric loading can result in increased synthesis of type I collagen. Thus, isolated eccentric loading appears to influence biochemical and biomechanical parameters and improve clinical outcomes.Oct 31, 2015
What is concentric and eccentric movement?
A concentric movement happens when your muscles contract, while an eccentric movement occurs when the muscle lengthens. The best example of both concentric and eccentric movements is the biceps curl. When you curl your arm up toward your shoulder, your arm muscles contract (a concentric movement).Oct 29, 2020
How do I strengthen my Achilles tendon for sprinting?
0:563:54Making the Achilles Tendon Stronger to RUN FASTER! - YouTubeYouTubeStart of suggested clipEnd of suggested clipWhich may allow you to work the area harder with minimal irritability another exercise you can tryMoreWhich may allow you to work the area harder with minimal irritability another exercise you can try is heel raises. This is a standard and staple way to build strength in both the calf.
How do you strengthen an Achilles tendon injury?
3 calf strengthening exercisesSit on a chair or at the edge of a bed. Place your feet shoulder-width apart.Lift your heels as high as possible, pause, then slowly lower them.Complete one set of 20 to 25 reps. Repeat 5 to 6 times each day.
What is Alfredson protocol?
The Alfredson protocol is a program of eccentric heel-drop exercises for treating Achilles tendinopathies. It has been widely adopted in research and clinical practice. The protocol recommends completion of 180 eccentric repetitions a day. 3. Currently, there is no strong rationale for this repetition volume.Feb 1, 2014
Anatomy
The achilles tendon is the terminal extension of the three posterior muscles in the lower leg: the soleus, gastrocnemius, and plantaris. The achilles tendon attaches (inserts) into the posterior calcaneus.
Causes
Overuse or overloading of the achilles tendon, from either too much volume or too high of an intensity of activity is a common cause of achilles tendonitis.
Treatment
Eccentric exercises of the calf had been demonstrated by Alfredson (1998) and others to improve the symptoms of Achilles tendonitis. Alfredson’s latest protocol for eccentric exercises has demonstrated a high rate of improvement of achilles tendonitis with the following protocol:
How to rehab Achilles tendon?
Your therapist may use various modalities and exercises to help achieve those goals. 1  While treatments like heat, ice, or massage may feel good, exercises should be the main focus of your Achilles tendon rehab.
How to get your Achilles tendon to heal?
Jump and land properly with your feet shoulder-width apart and do not allow your knees to buckle inwards or outwards while performing the exercises. These are advanced exercises, and if your Achilles tendon is not fully healed or ready for this kind of stress, you may risk getting re-injured.
What happens if you tear your Achilles tendon?
After an Achilles tendon tear, your balance and proprioception may become impaired. This can occur as a result of the injury or due to the period of immobilization while your tendon was healing. Your physical therapist may have you work on specific exercises to improve your balance.
How to get back to normal?
Working with a physical therapist is a good idea to help you get back to normal. Your therapist can show you which exercises to do—and when to do them—to fully recover. By doing the right exercises for your condition, you can quickly and safely get back to your normal lifestyle.
Why does my Achilles tendon feel tight?
When you suffer an Achilles tear, scar tissue will form around the tendon as it is healing. This, coupled with a period of immobilization, can make the tendon (and surrounding muscles) feel tight.
Can you walk with an Achilles tear?
If you have suffered an Achilles tendon rupture, then you know how painful and debilitating the injury can be. An Achilles tear can prevent you from walking normally and can limit your normal work and recreational activity. You may benefit from physical therapy (PT) for an Achilles tendon rupture.
What is eccentric training?
Eccentric training for the treatment of tendinopathies. Tendinopathy can result from overuse and is experienced in the affected tendon as pain with activity, focal tenderness to palpation, and decreased ability to tolerate tension, which results in decreased functional strength.
Can eccentric exercises help with tendinopathy?
Research has shown that an eccentric exercise program can be effective in the treatment of tendinopathies. The earliest studied was the Achilles tendon, and subsequent studies have shown benefits using eccentric exercises on other body regions including the patellar tendon, proximal lateral elbow, and rotator cuff.
Can tendinopathy cause pain?
Tendinopathy can result from overuse and is experienced in the affected tendon as pain with activity , focal tenderness to palpation, and decreased ability to tolerate tension, which results in decreased functional strength. While tendinopathy often occurs in those who are active, it can occur in those who are inactive.
What are eccentric exercises?
Eccentric exercises have been shown to be effective in the treatment of tendinopathies at various locations of the body. The area studied earliest was the Achilles, although benefits have been seen using eccentric exercises on other body regions including the patellar tendon, lateral elbow, and rotator cuff.
How to treat tendinopathy?
The current most common therapeutic exercise regimen for treatment of tendinopathy involves mechanically loading the painful or abnormal tissue with the use of eccentric exercises. Eccentric exercises involve lengthening of the musculotendinous unit while a load is applied to it. While eccentric muscle strengthening has been used for some time, until recently, little was known about how eccentric exercises result in decreased pain and normalization of the tendon in those with tendinopathy. Many of the studies included patients diagnosed with tendinopathy by history and physical examination alone, but some studies used imaging to confirm the diagnosis and/or rule out other causes of pain.
What is tendinopathy pain?
Tendinopathy is a term used commonly to describe any painful condition occurring within or around a tendon. It can result from overuse and is experienced as pain with activity, focal tenderness to palpation, and decreased ability to tolerate tension, which results in decreased functional strength ( 88 ). While some define tendinopathy and tendinosis differently, for simplicity, tendinopathy will be used in this article for both entities, and the treatment of symptomatic tendinopathy will focus on those with our macroscopic tendon tears, partial or complete. We will review the evidence for treating tendinopathy using an eccentric exercise program, address possible mechanisms by which eccentric exercises positively affect the tendon in the treatment of tendinopathies, and provide a framework for the implementation of an eccentric training program.
What are the risk factors for tendinopathy?
Risk factors for tendinopathy include intrinsic or extrinsic factors. Systemic intrinsic risk factors include older age ( 91,97 ), obesity ( 15,23,103 ), increased waist circumference ( 52 ), diabetes ( 14 ), hypertension ( 23 ), dyslipidemia ( 20 ), and genetic predisposition ( 48 ). The aging process may result in histologic findings similar or identical to those seen in tendinopathy, predisposing patients to partial tears and the development of pain ( 23 ). Obesity, increased waist circumference, diabetes, hypertension, and dyslipidemia all affect microvascularity, and this may play a key role in the development of tendinopathy. The lipid profile of some with Achilles tendinopathy is very similar to the lipid profile that is associated with increased insulin resistance ( 19 ). Furthermore lipid accumulation has been found in biopsies from tendinopathy subjects ( 19,102 ). In fact, one study gives dimensions of the Achilles tendon that can be used as a screening tool to diagnose those with familial hypercholesterolemia ( 10 ). Genetic risk factors for tendinopathy also have been described in several studies ( 31,32,43,48,58,59,68,71,82 ). An interaction between other risk factors and one’s genetic make-up may further increase the likelihood of developing tendinopathy ( 48 ). Nonsystemic intrinsic risk factors include abnormal biomechanics ( 3,37,62,104 ), muscle inflexibility ( 105 ), decreased muscle strength ( 20,49,50,51,76 ), malalignment ( 76 ), and joint laxity ( 76 ).
Can eccentric exercises help with tendinopathy?
Research has shown that an eccentric exercise program can be effective in the treatment of tendinopathies. The earliest studied was the Achilles tendon, and subsequent studies have shown benefits using eccentric exercises on other body regions including the patellar tendon, proximal lateral elbow, and rotator cuff.
How to strengthen Achilles tendon?
Improve Achilles’ tendon health, strength and stiffness. Increase ankle mobility. Coaching Cues: Use support to eliminate the balance component; This is not a balance exercise. Use a step, stack of books, curb, or other elevated surface. Place your ball of your foot or forefoot on the surface.
What is eccentric exercise?
Eccentric exercises are exactly that; they are slow, lengthening muscle contractions that are for a specific muscle. For example, if you imagine slowly lowering yourself down to sit into a chair, the slow motion of you going from a standing position to sitting is an eccentric contraction, or “negative”. If you never heard of an eccentric exercise, ...
Why is stiffness important in jumping?
The reason we want stiffness is that it allows your tendon to withstand high loads. The stiffness allows for proper energy storage, and the contract-relax portion of jump to occur. For example, think of the act of jumping as a spring. If the spring is too loose, it won’t store energy well and the rebound effect will be minimal. However, if the spring is tight when it is loaded, it will store more energy, create more force and lead to a greater vertical jump.
What happens if a spring is too loose?
If the spring is too loose, it won’t store energy well and the rebound effect will be minimal. However, if the spring is tight when it is loaded, it will store more energy, create more force and lead to a greater vertical jump. 3. Better Range of Motion. Eccentric training may improve your range of motion.
Does eccentric training improve range of motion?
Eccentric training may improve your range of motion. Studies have shown an increase in ankle range of motion following 6 weeks of eccentric loading. This improvement in range of motion is due to reduced resistance to passive stretching from improved muscle tendon unit compliance.
What is neural adaptation?
In other words, neural adaptations allow you to get stronger. As you perform eccentric training, your body and mind learns how to use the correct muscles (agonist) when lifting and shutting off the muscles that you are not supposed to be using (antagonist).
What muscles do basketball players use?
These exercises are geared to targeting the most important tendons of the lower body which include the quadriceps, adductors, hamstrings, and calf.