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

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    Author(s)
    Rees, J.
    Lichtwark, Glen
    Wolman, R.
    Wilson, A.
    Griffith University Author(s)
    Lichtwark, Glen A.
    Year published
    2008
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    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 ...
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    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.
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    Journal Title
    Rheumatology
    Volume
    47
    Publisher URI
    http://rheumatology.oxfordjournals.org/
    DOI
    https://doi.org/10.1093/rheumatology/ken262
    Copyright Statement
    © 2008 Oxford University Press. This is a pre-copy-editing, author-produced PDF of an article accepted for publication in Rheumatology following peer review. Please refer to the link for the definitive publisher-authenticated version.
    Subject
    Clinical sciences
    Biomechanics
    Immunology
    Publication URI
    http://hdl.handle.net/10072/22392
    Collection
    • Journal articles

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