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Evaluation of Eccentric Exercise in Treatment of Patellar Tendinitis

K Jensen, BS, PT, is Supervisor, Sports Medicine Physical Therapy Unit, University of Wisconsin Hospital and Clinics, Center for Health Sciences, 600 Highland Ave, Madison, WI 53792.
R Di Fabio, PhD, PT, is Director of Physical Therapy, University of Wisconsin Hospital and Clinics, Center for Health Sciences, 600 Highland Ave, Madison, WI 53792 (USA).

The purpose of this study was to analyze the effects of a quadriceps femoris muscle eccentric training program on strength gain in patients with patellar tendinitis. The effect of an eight-week eccentric exercise program on quadriceps femoris muscle work was evaluated in four groups of subjects—two groups of "normal" (healthy) subjects and two groups of patients with patellar tendinitis. All four groups participated in a home muscle stretching exercise program, but only two groups—one group of normal subjects (N-A) and one group of subjects with tendinitis (T-A)—received additional eccentric training on an eccentric isokinetic dynamometer. The eccentric quadriceps femoris muscle work ratio (involved limb/uninvolved limb x 100) was used to quantify strength in the N-A and T-A Groups. Pain ratings were recorded for subjects with tendinitis before and after the eight-week experiment and were correlated with the dependent variable using a Spearman rank-order correlation coefficient. The N-A Group performed significantly better than all subjects with tendinitis (p < .05). Subjects in the T-A Group, however, showed a trend toward increasing eccentric quadriceps femoris muscle work capacity over the eight-week training period. As pain ratings in the T-A Group increased, work ratios decreased. We concluded that eccentric exercise may be an effective treatment for patellar tendinitis, but that knee pain may limit optimal gains in strength.

Key Words: Exercise, strengthening • Knee injuries • Tendinitis • Tendon injuries

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