The role of eccentric exercise in sport injuries rehabilitation

British Medical Bulletin

Volumn 110, Issue 1, 2014, Pages 47-75

  Frizziero, Antonio ^a   Trainito, Sabina ^a   Oliva, Francesco ^b   Nicoli Aldini, Nicolò ^c   Masiero, Stefano ^a   Maffulli, Nicola ^d,e,f  

^a UNIVERSITY OF PADOVA   (Italy)

^b UNIVERSITY OF ROME TOR VERGATA   (Italy)

^c RIZZOLI ORTHOPAEDIC INSTITUTE   (Italy)

^d UNIVERSITY OF SALERNO   (Italy)

^e QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^f QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

Author keywords

Eccentric exercise; Ligament injuries; Rehabilitation; Sport injuries; Tendinopathy

Indexed keywords

ACHILLES TENDINITIS; ANTERIOR CRUCIATE LIGAMENT INJURY; ARTICLE; ATHLETIC REHABILITATION; BIOMECHANICS; COCHRANE LIBRARY; CONCENTRIC MUSCLE CONTRACTION; COST EFFECTIVENESS ANALYSIS; ECCENTRIC EXERCISE; ECCENTRIC MUSCLE CONTRACTION; EVIDENCE BASED MEDICINE; EXERCISE; HAMSTRING; HUMAN; INGUINAL PAIN; INTERMETHOD COMPARISON; LIGAMENT INJURY; MEDLINE; MUSCLE STRAIN; PATELLA TENDON; PATHOPHYSIOLOGY; PRIORITY JOURNAL; ROTATOR CUFF INJURY; SPORT INJURY; SUPRASPINATUS MUSCLE; TENDINITIS; TENNIS ELBOW; ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION; DATA BASE; FEASIBILITY STUDY; FOLLOW UP; INGUINAL REGION; KINESIOTHERAPY; MUSCLE EXERCISE; PAIN; PEDRO; PHYSIOTHERAPY; PRESCRIPTION; REHABILITATION CARE; SHOULDER INJURY; STANDARDIZATION; TENDON INJURY; ACHILLES TENDON; ATHLETIC INJURIES; INJURIES; MUSCLE CONTRACTION; PHYSIOLOGY; PROCEDURES; RADIATION; TENDINOPATHY; THERAPEUTIC USE;

ACHILLES TENDON; ATHLETIC INJURIES; EXERCISE THERAPY; HIGH-ENERGY SHOCK WAVES; HUMANS; MUSCLE CONTRACTION; TENDINOPATHY;

EID: 84901985909     PISSN: 00071420     EISSN: 14718391     Source Type: Journal    
DOI: 10.1093/bmb/ldu006     Document Type: Article

References (115)

1. Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: Where is the evidence?. Clin Sports Med 2012;31:329-50
2. Murtaugh B, Ihm JM. Eccentric training for the treatment of tendinopathies. Curr SportsMed Rep 2013;12:175-82
3. Rees JD, Lichtwark GA, Wolman RL, et al. The mechanism for efficacy of eccentric loading in Achilles tendon injury; an in vivo study in humans. Rheumatology (Oxford) 2008;47:1493-7
4. Rees JD, Wolman RL, Wilson A. Eccentric exercises; why do they work, what are the problems and how can we improve them?. Br J Sports Med 2009;43:242-6
5. Maffulli N, Longo UG, Loppini M, et al. Current treatment options for tendinopathy. Expert Opin Pharmacother 2010;11:2177-86
6. Frizziero A, Bonsangue V, Trevisan M, et al. Foot tendinopathies in rheumatic diseases: Etiopathogenesis, clinical manifestations and therapeutic options. Clin Rheumatol 2013;32:547-55
7. Torricelli P, Veronesi F, Pagani S, et al. In vitro tenocyte metabolism in aging and oestrogen Deficiency. Age (Dordr) 2013;35:2125-36
8. Frizziero A, Fini M, Salamanna F, et al. Effect of training and sudden Detraining on the patellar tendon and its enthesis in rats. BMC Musculoskelet Disord 2011;12:20, 2474-12-20
9. Rowe V, Hemmings S, Barton C, et al. Conservative management of midportion Achilles tendinopathy: A mixed methods study, integrating systematic review and clinical reasoning. Sports Med 2012;42:941-67
10. Woodley BL, Newsham-West RJ, Baxter GD. Chronic tendinopathy: Effectiveness of eccentric exercise. Br J Sports Med 2007;41: 188-99
11. Maffulli N, Longo UG, Denaro V. Novel approaches for the management of tendinopathy. J Bone Joint Surg Am 2010;92:2604-13
12. Andres BM, Murrell GA. Treatment of tendinopathy: What works, what does not, and what is on the horizon. Clin Orthop Relat Res 2008;466:1539-54
13. Wasielewski NJ, Kotsko KM. Does eccentric exercise reduce pain and improve strength in physically active adults with symptomatic lower extremity tendinosis?. A systematic review. J Athl Train 2007;42:409-21. (Pubitemid 47535687
14. Alfredson H, Pietila T, Jonsson P, et al. Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis. Am J Sports Med 1998;26:360-6. (Pubitemid 28248723
15. Mafi N, Lorentzon R, Alfredson H. Superior short-Term results with eccentric calf muscle training compared to concentric training in a randomized prospective multicenter study on patients with chronic Achilles tendinosis. Knee Surg Sports Traumatol Arthrosc 2001;9:42-7. (Pubitemid 33684587
16. Meyer A, Tumilty S, Baxter GD. Eccentric exercise protocols for chronic non-insertional Achilles tendinopathy: How much is enough?. Scand J Med Sci Sports 2009;19:609-15
17. Maffulli N, Longo UG. How do eccentric exercises work in tendinopathy?. Rheumatology (Oxford) 2008; 47:1444-5
18. Arampatzis A, Karamanidis K, Albracht K. Adaptational responses of the human Achilles tendon by modulation of the applied cyclic strain magnitude. J Exp Biol 2007;210(Pt 15):2743-53. (Pubitemid 47310808
19. Scott A, Alfredson H, Forsgren S. VGluT2 expression in painful Achilles and patellar tendinosis: Evidence of local glutamate release by tenocytes. J Orthop Res 2008;26:685-92
20. Andersson G, Danielson P, Alfredson H, et al. Presence of substance P and the neurokinin-1 receptor in tenocytes of the human Achilles tendon. Regul Pept 2008;150:81-7
21. Alfredson H, Lorentzon R. Intratendinous glutamate levels and eccentric training in chronic Achilles tendinosis: A prospective study using microdialysis technique. Knee Surg Sports Traumatol Arthrosc 2003;11:196-9. (Pubitemid 38249647
22. Ohberg L, Alfredson H. Effects on neovascularisation behind the good results with eccentric training in chronic mid-portion Achilles tendinosis?. Knee Surg Sports Traumatol Arthrosc 2004;12:465-70
23. Ohberg L, Lorentzon R, Alfredson H. Eccentric training in patients with chronic Achilles tendinosis: Normalised tendon structure and decreased thickness at follow up. Br J Sports Med 2004;38:8-11. (Pubitemid 38183592
24. Alfredson H. Conservative management of Achilles tendinopathy: New ideas. Foot Ankle Clin 2005;10:321-9. (Pubitemid 40732790
25. Allison GT, Purdam C. Eccentric loading for Achilles tendinopathy- strengthening or stretching?. Br J Sports Med 2009;43:276-9
26. Kramer R, Lorenzen J, Vogt PM, et al. Systematic review about eccentric training in chronic achilles tendinopathy. Sportverletz Sportschaden 2010;24:204-11
27. Silbernagel KG. Does one size fit all when it comes to exercise treatment for achilles tendinopathy?. J Orthop Sports Phys Ther 2014;44:42-4
28. Stasinopoulos D, Manias P. Comparing two eccentric exercise programmes for the management of Achilles tendinopathy. A pilot trial. J Bodyw Mov Ther 2013; 17:309-15
29. Fahlstrom M, Jonsson P, Lorentzon R, et al. Chronic Achilles tendon pain treated with eccentric calf-muscle training. Knee Surg Sports Traumatol Arthrosc 2003; 11:327-33. (Pubitemid 38251123
30. Jonsson P, Alfredson H, Sunding K, et al. New regimen for eccentric calf-muscle training in patients with chronic insertional Achilles tendinopathy: Results of a pilot study. Br J Sports Med 2008;42:746-9
31. Stanish WD, Rubinovich RM, Curwin S. Eccentric exercise in chronic tendinitis. Clin Orthop Relat Res 1986;208:65-8. (Pubitemid 16049770
32. Grigg NL, Wearing SC, Smeathers JE. Eccentric calf muscle exercise produces a greater acute reduction in Achilles tendon thickness than concentric exercise. Br J Sports Med 2009;43:280-3
33. Kjaer M, Heinemeier KM. 4. Eccentric exercise: Acute and chronic effects on healthy and diseased tendons. J Appl Physiol (1985) 2014; Jan 16
34. Komi PV, Buskirk ER. Effect of eccentric and concentric muscle conditioning on tension and electrical activity of human muscle. Ergonomics 1972;15:417-34
35. Frohm A, Saartok T, Halvorsen K, et al. Eccentric treatment for patellar tendinopathy: A prospective randomised short-Term pilot study of two rehabilitation protocols. Br J Sports Med 2007;41:e7
36. Deans VM, Miller A, Ramos J. A prospective series of patients with chronic Achilles tendinopathy treated with autologous-conditioned plasma injections combined with exercise and therapeutic ultrasonography. J Foot Ankle Surg 2012;51:706-10
37. Shalabi A, Kristoffersen-Wilberg M, Svensson L, et al. Eccentric training of the gastrocnemius-soleus complex in chronic Achilles tendinopathy results in Decreased tendon volume and intratendinous signal as evaluated by MRI. Am J Sports Med 2004;32:1286-96. (Pubitemid 38970385
38. van Der Plas A, de Jonge S, de Vos RJ, et al. A 5-year follow-up study of Alfredson's heel-drop exercise programme in chronic midportion Achilles tendinopathy. Br J Sports Med 2012;46:214-8
39. Nilsson-Helander K, Silbernagel KG, Thomee R, et al. Acute achilles tendon rupture: A randomized, controlled study comparing surgical and nonsurgical treatments using validated outcome measures. Am J Sports Med 2010;38:2186-93
40. Silbernagel KG, Thomee R, Thomee P, et al. Eccentric overload training for patients with chronic Achilles tendon pain-A randomised controlled study with reliability testing of the evaluation methods. Scand J Med Sci Sports 2001;11:197-206. (Pubitemid 33643506
41. Norregaard J, Larsen CC, Bieler T, et al. Eccentric exercise in treatment of Achilles tendinopathy. Scand J Med Sci Sports 2007;17:133-8
42. Yu J, Park D, Lee G. Effect of eccentric strengthening on pain, muscle strength, endurance, and functional fitness factors in male patients with Achilles tendinopathy. Am J Phys Med Rehabil 2013;92:68-76
43. Stevens M, Tan CW. Effectiveness of the alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: A randomized controlled trial. J Orthop Sports Phys Ther 2014;44:59-67
44. Rompe JD, Nafe B, Furia JP, et al. Eccentric loading, shock-wave treatment, or a wait-And-see policy for tendinopathy of the main body of tendo Achillis: A randomized controlled trial. Am J Sports Med 2007;35:374-83. (Pubitemid 46280497
45. Rompe JD, Furia J, Maffulli N. Eccentric loading versus eccentric loading plus shock-wave treatment for midportion Achilles tendinopathy: A randomized controlled trial. Am J Sports Med 2009;37:463-70
46. Rompe JD, Furia J, Maffulli N. Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy. A randomized, controlled trial. J Bone Joint Surg Am 2008;90:52-61
47. Notarnicola A, Maccagnano G, Tafuri S, et al. CHELT therapy in the treatment of chronic insertional Achilles tendinopathy. Lasers Med Sci 2013; Dec 19
48. Herrington L, McCulloch R. The role of eccentric training in the management of Achilles tendinopathy: A pilot study. Physical Therapy in Sport 2007;8:191-6. (Pubitemid 47611593
49. Paoloni JA, Appleyard RC, Nelson J, et al. Topical glyceryl trinitrate treatment of chronic noninsertional achilles tendinopathy. A randomized, double-blind, placebocontrolled trial. J Bone Joint Surg Am 2004;86-A: 916-22. (Pubitemid 38619789
50. Hunte G, Lloyd-Smith R. Topical glyceryl trinitrate for chronic Achilles tendinopathy. Clin J Sport Med 2005;15:116-7. (Pubitemid 40462894
51. Zhang BM, Zhong LW, Xu SW, et al. Acupuncture for chronic Achilles tendnopathy: A randomized controlled study. Chin J Integr Med 2013;19:900-4
52. Horstmann T, Jud HM, Frohlich V, et al. Whole-body vibration versus eccentric training or a wait-And-see approach for chronic Achilles tendinopathy: A randomized clinical trial. J Orthop Sports Phys Ther 2013;43:794-803
53. Pearson J, Rowlands D, Highet R. Autologous blood injection to treat Achilles tendinopathy?. A randomized controlled trial. J Sport Rehabil 2012;21:218-24
54. Bell KJ, Fulcher ML, Rowlands DS, et al. Impact of autologous blood injections in treatment of mid-portion Achilles tendinopathy: Double blind randomised controlled trial. Bmj 2013;346:f2310
55. de Vos RJ, Weir A, van Schie HT, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: A randomized controlled trial. Jama 2010;303:144-9
56. de Jonge S, de Vos RJ,Weir A, et al. One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: A double-blind randomized placebocontrolled trial. Am J Sports Med 2011;39:1623-9
57. Kearney RS, Parsons N, CostaML. Achilles tendinopathy management: A pilot randomised controlled trial comparing platelet-richplasma injection with an eccentric loading programme. Bone Joint Res 2013;2:227-32
58. de Jonge S, de Vos RJ, Van Schie HT, et al. One-year follow-up of a randomised controlled trial on added splinting to eccentric exercises in chronic midportion Achilles tendinopathy. Br J Sports Med 2010;44:673-7
59. de Vos RJ, Weir A, Visser RJ, et al. The additional value of a night splint to eccentric exercises in chronic midportion Achilles tendinopathy: A randomised controlled trial. Br J Sports Med 2007;41:e5
60. Roos EM, Engstrom M, Lagerquist A, et al. Clinical improvement after 6 weeks of eccentric exercise in patients with mid-portion Achilles tendinopathy - A randomized trial with 1-year follow-up. Scand J Med Sci Sports 2004;14:286-95. (Pubitemid 39360653
61. Knobloch K, Schreibmueller L, Longo UG, et al. Eccentric exercises for the management of tendinopathy of the main body of the Achilles tendon with or without an AirHeel Brace. A randomized controlled trial. B: Effects of compliance. Disabil Rehabil 2008;30:1692-6
62. Petersen W, Welp R, Rosenbaum D. Chronic Achilles tendinopathy: A prospective randomized study comparing the therapeutic effect of eccentric training, the AirHeel brace, and a combination of both. Am J Sports Med 2007;35:1659-67. (Pubitemid 47476054
63. Mayer F, Hirschmuller A, Muller S, et al. Effects of short-Term treatment strategies over 4 weeks in Achilles tendinopathy. Br J Sports Med 2007;41:e6
64. Stergioulas A, Stergioula M, Aarskog R, et al. Effects of low-level laser therapy and eccentric exercises in the treatment of recreational athletes with chronic achilles tendinopathy. Am J Sports Med 2008;36:881-7. (Pubitemid 351551243
65. Tumilty S, McDonough S, Hurley DA, et al. Clinical effectiveness of low-level laser therapy as an adjunct to eccentric exercise for the treatment of Achilles' tendinopathy: A randomized controlled trial. Arch Phys Med Rehabil 2012;93:733-9
66. Yelland MJ, Sweeting KR, Lyftogt JA, et al. Prolotherapy injections and eccentric loading exercises for painful Achilles tendinosis: A randomised trial. Br J Sports Med 2011;45:421-8
67. Brown R, Orchard J, Kinchington M, et al. Aprotinin in the management of Achilles tendinopathy: A randomised controlled trial. Br J Sports Med 2006;40:275-9. (Pubitemid 43384753
68. Malliaras P, Barton CJ, Reeves ND, et al. Achilles and patellar tendinopathy loading programmes: A systematic review comparing clinical outcomes and identifying potential mechanisms for effectiveness. Sports Med 2013;43:267-86
69. Cannell LJ, Taunton JE, Clement DB, et al. A randomised clinical trial of the efficacy of drop squats or leg extension/leg curl exercises to treat clinically diagnosed jumper's knee in athletes: Pilot study. Br J Sports Med 2001;35:60-4. (Pubitemid 32565053
70. Kongsgaard M, Kovanen V, Aagaard P, et al. Corticosteroid injections, eccentric decline squat training and heavy slow resistance training in patellar tendinopathy. Scand J Med Sci Sports 2009;19:790-802
71. Warden SJ, Metcalf BR, Kiss ZS, et al. Low-intensity pulsed ultrasound for chronic patellar tendinopathy: A randomized, double-blind, placebo-controlled trial. Rheumatology (Oxford) 2008;47:467-71
72. Dragoo JL, Wasterlain AS, Braun HJ, et al. Platelet-Rich Plasma as a Treatment for Patellar Tendinopathy: A Double-Blind, Randomized Controlled Trial. Am J Sports Med 2014;42:610-8
73. Frohm A, Halvorsen K, Thorstensson A. Patellar tendon load in Different types of eccentric squats. Clin Biomech (Bristol, Avon) 2007;22:704-11. (Pubitemid 46830825
74. Young MA, Cook JL, Purdam CR, et al. Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players. Br J Sports Med 2005;39:102-5. (Pubitemid 40179549
75. Jonsson P, Alfredson H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper's knee: A prospective randomised study. Br J Sports Med 2005;39:847-50. (Pubitemid 41564925
76. da Cunha RA, Dias AN, Santos MB, et al. Comparative Study of Two Protocols of Eccentric Exercise on Knee Pain and Function in Athletes with Patellar Tendinopathy: Randomized Controlled Study. Revista Brasileira De Medicina do Esporte 2012;18:167-70
77. Bahr R, Fossan B, Loken S, et al. Surgical treatment compared with eccentric training for patellar tendinopathy (Jumper's Knee). A randomized, controlled trial. J Bone Joint Surg Am 2006;88:1689-98. (Pubitemid 44200205
78. Stasinopoulos D, Stasinopoulos I. Comparison of effects of exercise programme, pulsed ultrasound and transverse friction in the treatment of chronic patellar tendinopathy. Clin Rehabil 2004;18:347-52. (Pubitemid 38697066
79. Steunebrink M, Zwerver J, Brandsema R, et al. Topical glyceryl trinitrate treatment of chronic patellar tendinopathy: A randomised, double-blind, placebo-controlled clinical trial. Br J Sports Med 2013;47:34-9
80. van Der Worp H, Zwerver J, Hamstra M, et al. No difference in effectiveness between focused and radial shockwave therapy for treating patellar tendinopathy: A randomized controlled trial. Knee Surg Sports Traumatol Arthrosc 2013; May 12
81. Lorenzen J, Kramer R, Vogt PM, et al. Systematic review about eccentric training in chronic patella tendinopathy. Sportverletz Sportschaden 2010;24:198-203
82. Visnes H, Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): A critical review of exercise programmes. Br J Sports Med 2007;41:217-23. (Pubitemid 350143331
83. Saithna A, Gogna R, Baraza N, et al. Eccentric Exercise Protocols for Patella Tendinopathy: Should we Really be Withdrawing Athletes from Sport?. A Systematic Review. Open Orthop J 2012;6:553-7
84. Visnes H, Hoksrud A, Cook J, et al. No effect of eccentric training on jumper's knee in volleyball players during the competitive season: A randomized clinical trial. Clin J Sport Med 2005;15:227-34
85. Raman J, MacDermid JC, Grewal R. Effectiveness of Different Methods of Resistance Exercises in Lateral Epicondylosis-A Systematic Review. Journal of Hand Therapy 2012;25:5-26
86. Slater H, Theriault E, Ronningen BO, et al. Exerciseinduced mechanical hypoalgesia in musculotendinous tissues of the lateral elbow. Man Ther 2010;15:66-73
87. Peterson M, Butler S, Eriksson M, et al. A randomized controlled trial of exercise versus wait-list in chronic tennis elbow (lateral epicondylosis). Ups J Med Sci 2011;116:269-79
88. Soderberg J, Grooten WJ, Ang BO. Effects of eccentric training on hand strength in subjects with lateral epicondylalgia: A randomized-controlled trial. Scand J Med Sci Sports 2012;22:797-803
89. Svernlov B, Adolfsson L. Non-operative treatment regime including eccentric training for lateral humeral epicondylalgia. Scand JMed Sci Sports 2001;11:328-34. (Pubitemid 33642159
90. Tyler TF, Thomas GC, Nicholas SJ, et al. Addition of isolated wrist extensor eccentric exercise to standard treatment for chronic lateral epicondylosis: A prospective randomized trial. J Shoulder Elbow Surg 2010;19: 917-22
91. Wen DY, Schultz BJ, Schaal B, et al. Eccentric strengthening for chronic lateral epicondylosis: A prospective randomized study. Sports Health 2011;3:500-3
92. Nagrale AV, Herd CR, Ganvir S, et al. Cyriax physiotherapy versus phonophoresis with supervised exercise in subjects with lateral epicondylalgia: A randomized clinical trial. J Man Manip Ther 2009;17:171-8
93. Viswas R, Ramachandran R, Korde Anantkumar P. Comparison of effectiveness of supervised exercise program and Cyriax physiotherapy in patients with tennis elbow (lateral epicondylitis): A randomized clinical trial. Scientificworldjournal 2012;2012:939645
94. Martinez-Silvestrini JA, Newcomer KL, Gay RE, et al. Chronic lateral epicondylitis: Comparative effectiveness of a home exercise program including stretching alone versus stretching supplemented with eccentric or concentric strengthening. J Hand Ther 2005;18:411-9
95. Zandt JF, Hahn D, Buchmann S, et al. May eccentric training be effective in the conservative treatment of chronic supraspinatus tendinopathies?. A review of the current literature. Sportverletz Sportschaden 2010; 24:190-7
96. Holmgren T, Hallgren HB, Oberg B, et al. Effect of specific exercise strategy on need for surgery in patients with subacromial impingement syndrome: Randomised controlled study. Br Med J 2012;344:e787
97. Ekstrand J. A common symptom among athletes and persons who exercise. Correct treatment of groin pain requires a meticulous diagnosis. Lakartidningen 1999;96:480-3
98. Nicholas SJ, Tyler TF. Adductor muscle strains in sport. Sports Med 2002;32:339-44. (Pubitemid 34450637
99. Valent A, Frizziero A, Bressan S, et al. Insertional tendinopathy of the adductors and rectus abdominis in athletes: A review. Muscles Ligaments Tendons J 2012;2:142-8
100. Maffulli N, Loppini M, Longo UG, et al. Bilateral miniinvasive adductor tenotomy for the management of chronic unilateral adductor longus tendinopathy in athletes. Am J Sports Med 2012;40:1880-6
101. Lynch SA, Renstrom PA. Groin injuries in sport: Treatment strategies. Sports Med 1999;28:137-44. (Pubitemid 29425545
102. Jensen J, Holmich P, Bandholm T, et al. Eccentric strengthening effect of hip-Adductor training with elastic bands in soccer players: A randomised controlled trial. Br J Sports Med 2014;48:332-8
103. Holmich P, Larsen K, Krogsgaard K, et al. Exercise program for prevention of groin pain in football players: A cluster-randomized trial. Scand J Med Sci Sports 2010;20:814-21
104. Holmich P, Uhrskou P, Ulnits L, et al. Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: Randomised trial. Lancet 1999;353:439-43. (Pubitemid 29067334
105. Holmich P, Nyvold P, Larsen K. Continued significant effect of physical training as treatment for overuse injury: 8- To 12-year outcome of a randomized clinical trial. Am J Sports Med 2011;39:2447-51
106. Weir A, Jansen JA, van De Port IG, et al. Manual or exercise therapy for long-standing adductor-related groin pain: A randomised controlled clinical trial. Man Ther 2011;16:148-54
107. Frizziero A, Ferrari R, Giannotti E, et al. The meniscus tear. State of the art of rehabilitation protocols related to surgical procedures. Muscles Ligaments Tendons J 2013;2:295-301
108. Gerber JP, Marcus RL, Dibble LE, et al. Effects of early progressive eccentric exercise on muscle size and function after anterior cruciate ligament reconstruction: A 1-year follow-up study of a randomized clinical trial. Phys Ther 2009;89:51-9
109. Gokeler A, Bisschop M, Benjaminse A, et al. Quadriceps function following ACL reconstruction and rehabilitation: Implications for optimisation of current practices. Knee Surg Sports Traumatol Arthrosc 2013; Jun 28
110. Sugiura Y, Saito T, Sakuraba K, et al. Strength deficits identified with concentric action of the hip extensors and eccentric action of the hamstrings predispose to hamstring injury in elite sprinters. J Orthop Sports Phys Ther 2008;38:457-64
111. Ahmad CS, Redler LH, Ciccotti MG, et al. Evaluation and Management of Hamstring Injuries. Am J Sports Med 2013;41:2933-47
112. Schache A. Eccentric hamstring muscle training can prevent hamstring injuries in soccer players. J Physiother 2012;58:58
113. Jonhagen S, Nemeth G, Eriksson E. Hamstring injuries in sprinters. The role of concentric and eccentric hamstring muscle strength and flexibility. Am J Sports Med 1994;22:262-6. (Pubitemid 24099346
114. Silder A, Sherry MA, Sanfilippo J, et al. Clinical and morphological changes following 2 rehabilitation programs for acute hamstring strain injuries: A randomized clinical trial. J Orthop Sports Phys Ther 2013;43: 284-99
115. Childress MA, Beutler A. Management of chronic tendon injuries. Am Fam Physician 2013;87:486-90