Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy

Alfons Mascaró; Miquel Àngel Cos; Antoni Morral; Andreu Roig; Craig Purdam; Jill Cook

doi:10.1016/j.apunts.2017.11.005

Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy

Título traducido de la contribución: Gestión de la carga en las tendinopatías: progresión clínica para tendinopatías de Aquiles y rotuliana

Alfons Mascaró^*
, Miquel Àngel Cos
, Antoni Morral
, Andreu Roig
, Craig Purdam
, Jill Cook

^*Autor/a de correspondencia de este trabajo

Facultad de Ciencias de la Salud Blanquerna

Producción científica: Artículo en revista indizada › Artículo › revisión exhaustiva

38 Citas (Scopus)

Resumen

Las tendinopatías de Aquiles y rotuliana son muy frecuentes. Las lesiones en estos tendones pueden afectar severamente a las actividades deportivas, recreativas y cotidianas. En las últimas 2 décadas, los ejercicios excéntricos se han convertido en la principal intervención conservadora para tratar las tendinopatías de Aquiles y rotuliana. Los ejercicios excéntricos no son efectivos en todos los pacientes afectados por tendinopatías (atletas y no atletas). Es posible que en atletas, la carga que genera el trabajo excéntrico sobre el músculo y el tendón sea insuficiente. Un programa de rehabilitación que tenga por objetivo aumentar la tolerancia del tendón a la carga debe, obviamente, incluir ejercicios de fuerza, pero también debe agregar ejercicios de velocidad y ejercicios que aumenten la capacidad para almacenar y liberar energía. Este trabajo muestra un protocolo de rehabilitación para las tendinopatías de Aquiles y rotuliana. Consiste en ejercicios simples y pragmáticos diseñados para incorporar carga progresiva al tendón: mediante trabajo isométrico, fuerza, fuerza funcional, velocidad y ejercicios pliométricos que aumenten en el tendón la capacidad de almacenar y liberar energía. Este trabajo es el primer paso para diseñar un ensayo clínico aleatorizado y multicéntrico que permita evaluar su eficacia

Título traducido de la contribución	Gestión de la carga en las tendinopatías: progresión clínica para tendinopatías de Aquiles y rotuliana
Idioma original	Inglés
Páginas (desde-hasta)	19-27
Número de páginas	9
Publicación	Apunts. Medicina de l'esport
Volumen	53
N.º	197
DOI	https://doi.org/10.1016/j.apunts.2017.11.005
Estado	Publicada - 1 feb 2018

Palabras clave

Tendinopatía
Aquiles
Rotuliana
Ejercicio
Carga
Terapia física

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10.1016/j.apunts.2017.11.005Licencia: Sin especificar

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title = "Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy",

abstract = "Achilles and patellar tendons are commonly affected by tendinopathy. Injury to these tendons can severely impact upon sports, recreational and everyday activities. Eccentric musculotendinous loading has become the dominant conservative intervention strategy for Achilles and patellar tendinopathy over the last two decades. Eccentric loading involves isolated, slow lengthening muscle contractions. Systematic reviews have evaluated the evidence for eccentric muscle loading in Achilles and patellar tendinopathy, concluding that outcomes are promising but high-quality evidence is lacking. Eccentric loading may not be effective for all patients (athletes and non-athletes) affected by tendinopathy. It is possible that in athletes, eccentric work is an inadequate load on the muscle and tendon. A rehabilitation program aiming to increase tendon load tolerance must obviously include strength exercises, but should also add speed and energy storage and release. The aim of this paper is to document a rehabilitation protocol for Achilles and patellar tendinopathy. It consists of simple and pragmatic exercises designed to incorporate progressive load to the tendon: isometric work, strength, functional strength, speed and jumping exercises to adapt the tendon to the ability to store and release energy. This article would be the first step for an upcoming multicentre randomized controlled trial to investigate its efficacy.",

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AU - Cos, Miquel Àngel

AU - Morral, Antoni

AU - Roig, Andreu

AU - Purdam, Craig

AU - Cook, Jill

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N2 - Achilles and patellar tendons are commonly affected by tendinopathy. Injury to these tendons can severely impact upon sports, recreational and everyday activities. Eccentric musculotendinous loading has become the dominant conservative intervention strategy for Achilles and patellar tendinopathy over the last two decades. Eccentric loading involves isolated, slow lengthening muscle contractions. Systematic reviews have evaluated the evidence for eccentric muscle loading in Achilles and patellar tendinopathy, concluding that outcomes are promising but high-quality evidence is lacking. Eccentric loading may not be effective for all patients (athletes and non-athletes) affected by tendinopathy. It is possible that in athletes, eccentric work is an inadequate load on the muscle and tendon. A rehabilitation program aiming to increase tendon load tolerance must obviously include strength exercises, but should also add speed and energy storage and release. The aim of this paper is to document a rehabilitation protocol for Achilles and patellar tendinopathy. It consists of simple and pragmatic exercises designed to incorporate progressive load to the tendon: isometric work, strength, functional strength, speed and jumping exercises to adapt the tendon to the ability to store and release energy. This article would be the first step for an upcoming multicentre randomized controlled trial to investigate its efficacy.

AB - Achilles and patellar tendons are commonly affected by tendinopathy. Injury to these tendons can severely impact upon sports, recreational and everyday activities. Eccentric musculotendinous loading has become the dominant conservative intervention strategy for Achilles and patellar tendinopathy over the last two decades. Eccentric loading involves isolated, slow lengthening muscle contractions. Systematic reviews have evaluated the evidence for eccentric muscle loading in Achilles and patellar tendinopathy, concluding that outcomes are promising but high-quality evidence is lacking. Eccentric loading may not be effective for all patients (athletes and non-athletes) affected by tendinopathy. It is possible that in athletes, eccentric work is an inadequate load on the muscle and tendon. A rehabilitation program aiming to increase tendon load tolerance must obviously include strength exercises, but should also add speed and energy storage and release. The aim of this paper is to document a rehabilitation protocol for Achilles and patellar tendinopathy. It consists of simple and pragmatic exercises designed to incorporate progressive load to the tendon: isometric work, strength, functional strength, speed and jumping exercises to adapt the tendon to the ability to store and release energy. This article would be the first step for an upcoming multicentre randomized controlled trial to investigate its efficacy.

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KW - Patellar

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Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy

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