Eccentric loading for Achilles tendinopathy — strengthening or stretching?

The prescription of eccentric loading is considered as a mainstay of non-operative rehabilitation programmes for mid-substance chronic Achilles tendinopathy. Such exercises have some degree of clinical utility in comparison with concentric training and are often referred to as a strengthening programme. Yet the dose parameters of the eccentric loading do not reflect an optimal strengthening programme and specifically avoid the normal eccentric–concentric coupling typical of the stretch shortening cycle. This manuscript identifies the arguments and counterarguments for why eccentric loading rehabilitation is not an optimal strengthening programme. It is proposed that such exercises reflect a specific stretching programme directed at the passive structures. This has two important clinical implications. Firstly, this reinterpretation of the role of eccentric exercises may direct future research into the underlying mechanisms of tendinopathy and, secondly, it may reinforce the importance of adjunct sports specific strengthening programmes. [ABSTRACT FROM AUTHOR]

Copyright of British Journal of Sports Medicine is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)