Abstract
Eccentric Training for the Treatment of Patellar Tendinosis: A Case Study
The journal of orthopaedic and sports physical therapy, v 36(1), pp A19-A19
01 Jan 2006
Abstract
Background and Purpose: Patellar tendinosis is a condition caused by repetitive, high load forces that exceed the inherent strength of the muscle-tendon unit. These forces initially cause an inflammatory response and, if left untreated, ultimately lead to degeneration of the tendon fibers and subsequent pain and dysfunction. Historically, chronic patellar tendinosis has been misdiagnosed and treated as a tendonitis despite the absence of inflammatory cells in the diseased tissue. Because of this, outcomes using antiinflammatory treatment interventions have been unsuccessful. One treatment that has been effective in treating chronic Achilles tendinosis has been eccentric strengthening exercises; however, there are no comparable studies for use of eccentric training in patients with patellar tendinosis. The purpose of this case study was
to apply the principles used in the treatment of Achilles tendinosis to treatment of a patient with patellar tendinosis.
Case Description: The patient was a 24-year-old male with an 8-year history of patellar tendon pain located just distal to the
inferior pole of the patella. The patient played recreational basketball and performed daily basketball-like activities for his job with a collegiate team. His symptoms were localized solely to the specific area described and increased with activities requiring eccentric contractions or deep knee flexion. The intervention for this patient was an eccentric training program for his quadriceps muscles. The patient performed 3 sets of 15 of 2 exercises, twice daily, 5 days a week for 8 weeks. The first exercise was non-weight bearing knee extensions; the second was weight-bearing leg presses. The patient was instructed to use either his upper extremity or bilateral lower extremities to assist with the concentric contraction and to perform the eccentric contraction unilaterally. The exercises were progressed by adding weight and the patient was instructed to stop the exercises if he experienced extreme pain.
Outcomes: After 8 weeks of intervention (6 total treatments), the patient reported that he was experiencing no pain and was able to return to his full activity level without an increase in symptoms. The patient also demonstrated improved strength and higher scores on the following outcome measures: Victoria Institute of Sport Assessment Scale, Activities of Daily Living of the Knee Outcome Survey and the Global Rating of Knee Function.
Discussion: This case study demonstrates successful results using eccentric strengthening as an intervention for a patient with patellar tendinosis. The results are similar to the studies that utilized eccentric strengthening for patients with Achilles
tendinosis. Further research is required in this area to enable generalization of these results, better understanding of the cellular level changes occurring and application of this treatment concept to tendinosis in other regions of the body.
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Details
- Title
- Eccentric Training for the Treatment of Patellar Tendinosis: A Case Study
- Creators
- Kevin E Gard - Drexel University, Physical Therapy (and Rehabilitation Sciences)D Epstein - Drexel UniversityDuane David Ebaugh
- Publication Details
- The journal of orthopaedic and sports physical therapy, v 36(1), pp A19-A19
- Conference
- American Physical Therapy Association (APTA) Combined Sections Meeting (CSM 2006) (San Diego, California, United States, 02 Feb 2006–05 Feb 2006)
- Number of pages
- 1
- Resource Type
- Abstract
- Language
- English
- Academic Unit
- Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 991020650713704721