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20 They reported significantly greater pain relief immediately postintervention following a single session of isometric exercise when compared with isotonic exercise in a small sample of volleyball players with patellar tendinopathy. There has been recent clinical and research interest in isometric exercise programmes in the management of tendinopathy since the study by Rio and colleagues in 2015. 18 Importantly however, the tendon lengthens when subjected to loading, regardless of muscle contraction type. 15–17 In contrast to isotonic exercise, in which the tension in the muscle remains constant despite a change in length, the muscle-tendon unit remains at a constant length during isometric exercise.
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11–14 Although the benefits of loading programmes are well recognised, 35%–45% of individuals do not experience a significant reduction in symptoms from either eccentric or combined concentric/eccentric exercise. 11–14 However, eccentric loading has not been consistently found to be superior when compared with combined concentric/eccentric programmes. 6–10 Different types of exercise or ‘loading’ programmes have been investigated, with those focusing on eccentric exercises the most commonly researched. 4 5Įxercise programmes are usually the first-line treatment for tendinopathy, and evidence of their effectiveness in reducing pain and improving function has been demonstrated. 4 Both the upper and lower limbs are involved, with the rotator cuff, lateral elbow, gluteal, patellar and Achilles tendons commonly affected. 2 It affects both sedentary 3 and active individuals and is responsible for 30%–50% of all sporting injuries.
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1 The burden of disease associated with tendinopathy is significant, accounting for 30% of all musculoskeletal conditions seen in general practice. Tendinopathy is the preferred term for persistent tendon pain and loss of function due to mechanical loading.