What is Eccentric Loading?
In order to properly explain the benefits of eccentric loading for Achilles tendinopathies, a basic understanding of the differences between concentric and eccentric phases of an exercise is required. A simple example is the calf raise exercise. Contracting the calves to stand up on your toes is the concentric phase. The slow and controlled movement back down is the eccentric phase. In this phase, the muscle is still contracting because we do not quickly drop our heels back to the ground; instead we control the downward movement. The muscle is elongating in this phase, but still remains under tension. It has been clinically shown that during the eccentric phase, the muscle can be loaded with much more weight compared to the concentric phase1. Another benefit of eccentric strengthening is that it increases the tensile strength of the tendons2.
How does this apply to Achilles’ Tendinopathies?
By performing the below eccentric strengthening exercises, the Achilles’ tendon will increase in tensile strength due to the increased collagen production that is stimulated by eccentric exercise3. In addition, the gastrocnemius and soleus muscles of the lower leg increase in strength as well due to the heavy load placed on them. This results in less pain in the affected area. According to Karin Grävare Silbernagel, PT, ATC, PhD, a leader in tendinopathy research, there are several exercises that are essential in reducing pain and improving function for those with Achilles’ tendinopathies. One important exercise is the eccentric gastrocnemius heel drop, shown below5. For more exercises and to get started on your rehabilitation process give us a call and make an appointment with us!
Eccentric Gastrocnemius Heel Drop3
Begin the exercise by standing on top of a step with heels hanging off the edge. Then, keeping your legs straight, contract the calf muscles and raise both heels upwards. Shift your weight over to the affected leg and SLOWLY, a 3-4 second count, lower the heel back down to parallel with the floor. Once this becomes easier, you can drop your heels below the step for greater range of motion through the movement. To repeat, use both legs to raise back up and one leg to lower down. This puts a much stronger force on the muscles in the eccentric phase of the exercise, producing the benefits stated above. Perform this exercise twice daily for 2 sets of 15 repetitions.
Helpful Hint: Increase the flexibility of these lower leg muscles with a simple calf/soleus stretch.
The information provided on this site is not intended as a substitute for advice from your physician or other health care professional, or any information contained on or in any product label or packaging. Please consult with a health care professional before starting any diet, exercise or supplementation program, before taking any medication, or if you suspect you might have a health problem.
- Herzog, W., Leonard, T.R., Joumaa, V. and Mehta, A. (2008). Mysteries of muscle contraction. Journal of Applied Biomechanics, 24, 1-13.
- Silbernagel, K. G., R. Thomee, B. I. Eriksson, and J. Karlsson. “Continued Sports Activity, Using a Pain-Monitoring Model, During Rehabilitation in Patients With Achilles Tendinopathy: A Randomized Controlled Study.”The American Journal of Sports Medicine35.6 (2007): 897-906. Web.