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Clin J Sport Med. 2017 May;27(3):253-259. doi: 10.1097/JSM.0000000000000364.

Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial.

Author information

1
*Department of Physiotherapy, Monash University, Victoria, Australia; †Australian Centre for Research into Injury in Sport and its Prevention, La Trobe University Bundoora, Victoria, Australia; ‡University of Groningen, University Medical Center Groningen, Groningen, Netherlands; §University of South Australia and PainAdelaide; ¶College of Science, Health and Engineering, School of Allied Health, Department of Rehabilitation, Nutrition and Sport, La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Australia; and ‖Faculty of Health, University of Canberra Research Institute for Sport and Exercise.

Abstract

OBJECTIVE:

This study aimed to compare the immediate analgesic effects of 2 resistance programs in in-season athletes with patellar tendinopathy (PT). Resistance training is noninvasive, a principle stimulus for corticospinal and neuromuscular adaptation, and may be analgesic.

DESIGN:

Within-season randomized clinical trial. Data analysis was conducted blinded to group.

SETTING:

Subelite volleyball and basketball competitions.

PARTICIPANTS:

Twenty jumping athletes aged more than 16 years, participating in games/trainings 3 times per week with clinically diagnosed PT.

INTERVENTIONS:

Two quadriceps resistance protocols were compared; (1) isometric leg extension holds at 60 degrees knee flexion (80% of their maximal voluntary isometric contraction) or (2) isotonic leg extension (at 80% of their 8 repetition maximum) 4 times per week for 4 weeks. Time under load and rest between sets was matched between groups.

MAIN OUTCOME MEASURES:

(1) Pain (0-10 numerical rating score) during single leg decline squat (SLDS), measured preintervention and postintervention sessions. (2) VISA-P, a questionnaire about tendon pain and function, completed at baseline and after 4 weeks.

RESULTS:

Twenty athletes with PT (18 men, mean 22.5 ± 4.7 years) participated (isotonic n = 10, isometric n = 10). Baseline median SLDS pain was 5/10 for both groups (isotonic range 1-8, isometric range 2-8). Isometric contractions produced significantly greater immediate analgesia (P < 0.002). Week one analgesic response positively correlated with improvements in VISA-P at 4 weeks (r = 0.64).

CONCLUSIONS:

Both protocols appear efficacious for in-season athletes to reduce pain, however, isometric contractions demonstrated significantly greater immediate analgesia throughout the 4-week trial. Greater analgesia may increase the ability to load or perform.

PMID:
27513733
DOI:
10.1097/JSM.0000000000000364
[Indexed for MEDLINE]

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