Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain: an in-season randomized clinical trial
Date
2017
Authors
Rio, E.
van Ark, M.
Moseley, G.L.
Kidgell, D.
Gaida, J.E.
van den, A.S.I.
Zwerver, J.
Cook, J.
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Journal article
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Clinical Journal of Sport Medicine, 2017; 27(3):253-259
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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 6 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 (r2 = 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.
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Copyright 2016 Wolters Kluwer Health Inc.