Exercise for tendinopathy

Abstract

Tendinopathies are one of the most common sports/musculoskeletal injury in modern western societies. Many physiotherapy approaches have been recommended in the literature for the management of tendinopathy. The most effective treatment in the management of tendinopathy is the eccentric training. Load, speed and frequency of contractions are the three principles of eccentric exercises, discussed in this report. However, eccentric training is not effective for all patients with tendinopathy and the effectiveness of this approach when applied as monotherapy is lower than it is applied as part of the rehabilitation process. For this reason, clinicians combine eccentric training with other physiotherapy techniques such as stretching, isometric and lumbar stability exercises, electrotherapy, manual therapy, soft tissue manipulation techniques, taping and acupuncture in the management of tendinopathies. Further research is needed to find out which treatment strategy combined with eccentric training will provide the best results in the rehabilitation of tendinopathy.

Keywords: Tendinopathy; Exercise; Physiotherapy; Electrotherapy; Eccentric exercises; Stretching exercises; Electrotherapy; Manual therapy

Core tip: Eccentric exercises are effective in the management of tendinopathy. Eccentric training improves patients’ symptoms and reverses tendinopathys’ pathology. The ideal eccentric protocol is unknown in the literature. Eccentric training alone does not respond positively in many patients. Therefore, clinicians combine eccentric training with other forms of therapy such as stretching exercises, isometric contraction, electrotherapy, manual therapy, deep transverse friction, taping, acupuncture and improvement of lumbo - pelvic control. More research is needed to find out which treatment strategy combined with eccentric training will provide the best results in the rehabilitation of tendinopathy.