The mechanism for efficacy of eccentric loading in Achilles tendon injury; an in vivo study in humans

Rees, JD, Lichtwark, GA, Wolman, RL and Wilson, AM (2008) The mechanism for efficacy of eccentric loading in Achilles tendon injury; an in vivo study in humans. Rheumatology, 47 10: 1493-1497. doi:10.1093/rheumatology/ken262

Author Rees, JD
Lichtwark, GA
Wolman, RL
Wilson, AM
Title The mechanism for efficacy of eccentric loading in Achilles tendon injury; an in vivo study in humans
Journal name Rheumatology   Check publisher's open access policy
ISSN 1462-0332
Publication date 2008-10-01
Sub-type Article (original research)
DOI 10.1093/rheumatology/ken262
Volume 47
Issue 10
Start page 1493
End page 1497
Total pages 5
Editor Moots, R
Place of publication Oxford , U.K.
Publisher Oxford University Press
Language eng
Subject 1106 Human Movement and Sports Science
Abstract Objective. Degenerative disorders of tendons present an enormous clinical challenge. They are extremely common, prone to recur and existing medical and surgical treatments are generally unsatisfactory. Recently eccentric, but not concentric, exercises have been shown to be highly effective in managing tendinopathy of the Achilles (and other) tendons. The mechanism for the efficacy of these exercises is unknown although it has been speculated that forces generated during eccentric loading are of a greater magnitude. Our objective was to determine the mechanism for the beneficial effect of eccentric exercise in Achilles tendinopathy. Methods. Seven healthy volunteers performed eccentric and concentric loading exercises for the Achilles tendon. Tendon force and length changes were determined using a combination of motion analysis, force plate data and real-time ultrasound. Results. There was no significant difference in peak tendon force or tendon length change when comparing eccentric with concentric exercises. However, high-frequency oscillations in tendon force occurred in all subjects during eccentric exercises but were rare in concentric exercises (P<0.0001). Conclusion. These oscillations provide a mechanism to explain the therapeutic benefit of eccentric loading in Achilles tendinopathy and parallels recent evidence from bone remodelling, where the frequency of the loading cycles is of more significance than the absolute magnitude of the force.
Keyword tendon
eccentric exercise
Q-Index Code C1
Q-Index Status Provisional Code

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Human Movement and Nutrition Sciences Publications
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Created: Tue, 15 Jun 2010, 22:01:55 EST