Objective: This article provides an overview of the efficacy of current exercise interventions for managing tendinopathy, and reviews the more up-to-date exercise prescriptions, such as the use of prolonged isometric contractions and tempo-driven strength training to suppress intracortical inhibition.
Discussion: The term tendinopathy is a widely accepted generic term that encompasses any abnormal condition affecting a tendon. While various medical conditions such as diabetes, prior use of fluoroquinolone antibiotics and/or hypercholesterolemia greatly increase the risk of developing a tendon injury, these injuries are most frequently the result of overuse, explaining the high prevalence in people participating in sports, particularly explosive sports such as basketball, soccer, and/or volleyball. Older athletes are especially prone to tendinopathy because of age-related decreases in tendon resiliency. Recent research shows that cortical inhibition develops following tendon injury and frequently results in impaired motor output to the damaged tendon that perpetuates chronicity. Performing prolonged isometric contractions and exercising to the beat of a metronome have been shown to suppress cortical inhibition, and these interventions should be considered in the management of all tendon injuries.
Conclusion: Rehabilitative exercises are discussed, including the importance of strengthening synergistic muscles in an attempt to offload the damaged tendon, the need to move through a full range of triplanar motion while performing rehabilitative exercises, and the benefits of strengthening tendons and muscles while they are in their lengthened positions. A detailed exercise protocol for managing non-insertional Achilles tendinopathy is reviewed, and this exercise routine can be modified to treat any tendon in the body.
Author keywords: Tendinopathy; Prolonged Isometric Contractions; Tempo-Driven Strength Training; Metronome; Intracortical Inhibition; Interfascicular Gliding.
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