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The effects of an eccentric-type exercise versus a concentric-type exercise in the management of chronic patellar tendonitis Cannell, Lynda Jane


The main purpose of this study was to determine which method of tendon rehabilitation - the "eccentric squat" exercise or the universal gym "leg extension/leg curl" exercise produces a more significant result in terms of recovery in the treatment of chronic patellar tendonitis. A second objective was to determine if a relationship existed between patients who presented with patellar tendonitis and certain biomechanical malalignments and/or muscle imbalances that those patients might have possessed. Nineteen patients with chronic patellar tendonitis were studied. They were selected on the basis that they had a history of athletic participation, wore no orthotics and had had the symptoms of patellar tendonitis greater than four weeks. Subjects were randomly placed in either of two groups: training using the "eccentric squat" exercise or training using the "leg extension/ leg curl" exercise. Subjects were clinically and biomechanically examined by a physician and placed on the twelve week exercise program. They were examined and tested at 0, 6 and 12 weeks. Testing included the following variables: thigh circumference measured 4.4 and 10 centimeters above the medial knee joint line, quadricep and hamstring moment of force as measured on the Cybex at 30 degrees per second and a subjective evaluation of pain rated on a scale from 1 to 10. There was no significant difference between the groups in either quadricep or hamstring moment of force, however hamstring moment of force significantly increased in both groups. There was a significant difference in pain ratings between the groups averaged over the three testing sessions (p <0.01). The group training with the "eccentric squat" exercise decreased in pain more than the group performing the "leg extension/leg curl" exercise. Also, the "eccentric squat" group produced twice as many "pain free" subjects at the end of the program than the other group. With the retrospective clinical data on the 129 patellar tendonitis patients seen at the B.C. Sports Medicine Clinic over a three year period, it appears that the average structural malalignment of the patellar tendonitis patient is no different from the average biomechanical problems any athlete may present with who has any number of difference overuse problems. It appears indicated to recommend the use of the "eccentric squat" exercise as an approach towards the conservative management of chronic patellar tendonitis.

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