Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain

An in-season randomized clinical trial

Ebonie Rio, Mathijs Van Ark, Sean Docking, G. Lorimer Moseley, Dawson Kidgell, Jamie E. Gaida, Inge van den Akker-Scheek, Johannes Zwerver, Jill Cook

Research output: Contribution to journalArticle

23 Citations (Scopus)

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 ± 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 (r 2 = 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.

Original languageEnglish
Pages (from-to)253-259
Number of pages7
JournalClinical Journal of Sport Medicine
Volume27
Issue number3
DOIs
Publication statusPublished - 1 May 2017

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Isotonic Contraction
Patellar Ligament
Isometric Contraction
Athletes
Tendinopathy
Analgesics
Leg
Randomized Controlled Trials
Analgesia
Pain
Volleyball
Basketball
Aptitude
Resistance Training
Tendons
Knee
Research Design
Outcome Assessment (Health Care)

Cite this

Rio, Ebonie ; Van Ark, Mathijs ; Docking, Sean ; Moseley, G. Lorimer ; Kidgell, Dawson ; Gaida, Jamie E. ; van den Akker-Scheek, Inge ; Zwerver, Johannes ; Cook, Jill. / Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain : An in-season randomized clinical trial. In: Clinical Journal of Sport Medicine. 2017 ; Vol. 27, No. 3. pp. 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 ± 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 (r 2 = 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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Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain : An in-season randomized clinical trial. / Rio, Ebonie; Van Ark, Mathijs; Docking, Sean; Moseley, G. Lorimer; Kidgell, Dawson; Gaida, Jamie E.; van den Akker-Scheek, Inge; Zwerver, Johannes; Cook, Jill.

In: Clinical Journal of Sport Medicine, Vol. 27, No. 3, 01.05.2017, p. 253-259.

Research output: Contribution to journalArticle

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T1 - Isometric contractions are more analgesic than isotonic contractions for patellar tendon pain

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AU - Rio, Ebonie

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