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Tendon Injury Rehabilitation Under Review

Usian Bolt

Usian Bolt has a fantastic ability to absorb and release energy through his Achilles tendon, but the extra load increases the risk of injury. Source: Wikimedia Commons

By Peter Malliaras

A review finds poor evidence for a common rehabilitation intervention used by physiotherapists to treat tendon injuries.

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Most people that suffer a tendon overuse injury are prescribed exercise as part of their treatment. Over the past 15 years the most popular form of exercise that clinicians prescribe has been “eccentric” exercise. This is where the muscle is loaded while it is lengthening, such as the downwards phase of a biceps curl. In contrast, “concentric” exercise is where the muscle shortens while under load, such as the upwards phase of a biceps curl.

Experts in the field know that eccentric exercise is not the only way to rehabilitate tendons, and in some cases other types of exercise may be more beneficial. Now, a review published by an international research group in Sports Medicine, the highest ranking journal in the field, has questioned the value of eccentric exercise for Achilles and patellar tendon injuries.

We undertook a systematic review of evidence comparing this approach to other rehab approaches, and found no compelling evidence for its superiority. In fact, there was equal or higher level evidence for other forms of exercises. The review provides convincing evidence that clinicians should consider other forms of exercise when rehabilitating tendon overuse injury.


Painful overuse injuries are common in tendons that endure high forces, such as the Achilles and patellar tendons. These injuries have a gradual onset without...

The full text of this article can be purchased from Informit.