Tuesday, June 05, 2007

Painful Eccentric Training for Tendonosis = FUN!

A couple of months ago, I was talking with Bryan Chung, MD, PhD (and a bunch of other letters after his name) from www.evidencebasedfitness.blogspot.com about why eccentric training, particularly painful eccentric training (how fun!!), showed such improvements in subject pain complaints in those with previously painful conditions like patellar tendonosis or achilles tendonosis.

He mentioned that the eccentric contractions obliterated the neomicrocirculation (new capillaries) that entered the tendon and pain reduction resulted.

Pretty cool, eh?

I was reading the new Journal of Orthopedic and Sports Physical Therapy during lunch and came across an article that showed similar findings. With 12 weeks of painful eccentric training came a 45% reduction in paratendon blood flow AND a 48% reduction in pain. No negative effects were found in the paratendinous tissues.

Those of you dealing with painful conditions like patellar tendonosis (your doc may be calling it tendonitis and may very well be wrong...tendonitis usually clears up in a couple weeks, tendonosis doesn't), tennis elbow, golfers elbow, achilles tendonosis, etc., you may want to consider adding 3 sets of 12-15 reps of daily, painful eccentric training to your program.

Yeah, it doesn't sound fun, but there's good evidence that it'll be helpful.

Bill

130 comments:

Anonymous said...

Good stuff Bill (and Bryan)!

Is there a Particular tempo you would recommend?

And for patellar problems would you have someone do eccentric lunges or (gasp) put them on a machine?

Thanks,

Chris B

Bill Hartman said...

Eccentric single leg squat with heels elevated. It smarts but works well.

Bill Hartman said...

Eccentric single leg squat with heels elevated. It smarts but works well.

Anonymous said...

Thanks Bill.

I'm going to work that with one of my current clients.

Chris

Anonymous said...

for my achilles tendon i think eccentric calf raises may work, right? should i do them loaded? (i don't have pain with doing eccentrics with bodyweight....)

Anonymous said...

There's a video of eccentric squats used to treat patellar tendinosis at http://eccentric-exercises.blogspot.com

Also, YouTube has a video of such exercises:
http://www.youtube.com/watch?v=wY98htXP0O4

Anonymous said...

Bill,

What movements would you recommend for golfer's elbow?

Thanks,

Tom

Tawana said...

Is there movements recommended for the front of the ankle. Every search I do results in achilles info, my ankles both hurt in the very front and extends onto the top of the foot, over 4 months now. Thanks for any info!!

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