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Eccentric exercises (EE) may sound complicated, but you actually do them all the time without knowing it. Every time you lengthen a muscle while applying a load you are already into EE. For instance, when you lower your hips to squat or your arms when doing a bicep curls. Gym rats may be familiar on how emphasizing the eccentric part of an exercise makes stronger muscles—you can handle more weight when lowering the muscle than when shortening it (concentric).

However, EE has also shown to decrease pain in those who struggle with a tendon injury. If you workout and/or practice sports, chances are you have dealt with the anxiety of an injury. Often, these injuries involve the tendons. Indeed, according to the article “Eccentric Training for Treatment of Tendinopathies” published in Current Sports Medicine Reports, more than 30% injuries related to physical activity have an element of pain within or around a tendon—tendinopathy.

There are many factors that may increase your risk of tendon injuries, such as tight muscle, lack of strength, doing too much too soon, compromising exercise techniques, and/or certain medication. After being injured myself plenty of times—from ankle and hamstring sprains to runner’s knee to tennis elbow—the focal tendon tenderness, inability to tolerate tension, and decrease in strength are almost always evident.

Exercise Rx for Injury Tendon

Researchers explain that in most cases the tendon involved may show no sign of inflammation. Instead, what is seen is a disruption of the tendon—a process in which collagen and other connective tissue cells formation has been disrupted. There is some speculation these factors can alter local metabolism and produce byproducts that cause pain.

With the onset of pain you may have already tried the standard procedures for the immediate care of soft tissue injuries— ice, compression, elevation, rest, and/or analgesics. However, with many tendon injuries, the pain just doesn’t seem to go away and it is common for a nagging tendon injury to last months. If this is the case, EE may be the right medicine. “Eccentric exercises may cause unique changes in the metabolism of the tendon, which results in altered pain perception,” says Bryan Murtaugh, M.D. and Joseph M. Ihm, M.D. in the Current Sports Medicine Reports article.

During eccentric exercise (or during the eccentric phase of an exercise movement) the tendon is subjected to a different pattern of loading and unloading than during concentric exercise (or during the concentric phase of an exercise). The authors believe this variation in loading and unloading—along with the tendons forces fluctuations—accounts for the difference in the soft tissue remodeling (i.e. this includes collagen realignment and the generation of Type I collagen).

Indeed, in a study in which subjects with Achilles tendinopathy (pain in the Achilles tendon area) were put in an EE program, they experienced an increase in the type I collagen, which is the main type of collagen in healthy tendons, as well as decreased pain.

EE Workout: Stronger Muscles and Tendons

In every dynamic exercise there are two types of contractions: concentric (shortening the muscle) and eccentric (lengthening the muscle) so you can emphasize the later in any resistance move.  Yet, there are some exercises in which taking advantage of the higher forces muscles can stand when lengthening work best.

It’s worth mentioning that when done properly EE may induce muscle soreness, and since collagen synthesis has been shown to peak at 24 hours and decrease toward the baseline at 72 hours, make sure to leave enough days in between workouts for recovery. Also, prior to jumping into EE, you should ask your doctor and/or physical therapist if you are already experiencing tendinopathy in order to perform the right exercises for your injury condition.

 

EE Workout Guidelines

–        Perform 3 sets of 12-15 reps of each exercise

–        Highlight the eccentric part of each exercise. This is to lengthening the muscles in control

–        Make sure every reps count so increase the weight gradually as you make progress

–        Do this workout twice a week on non-consecutive days

 

1. Barbell chest press (eccentric emphasis/training tip). Lower bar slowly (2 to 3 seconds) toward the chest until the shoulders are parallel to the ground.

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2. Lat pull-down (Not Shown)  (Eccentric emphasis/training tip). Extend the arms slowly (2 to 3 seconds) but do not “lock out” the elbows or rest at the top of the movement. Instead, hold the bar with the elbows in a “soft position” for a second keeping the lats under tension.

3. Romanian deadlift (Eccentric emphasis/training tip). Bend forward slowly at the hips (2 to 3 seconds) without bending or rounding out the lower back. As the bar is lowered you should feel an intense stretch in the back of the thighs (i.e. hamstrings).  Keep the bar as close to your thighs and shins as possible.

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4. Barbell rollout for the abs  (Eccentric emphasis/training tip).  While keeping your knees stationary on the floor and your arms taut, slowly (2 to 3 seconds) roll the barbell forward (or ab-roller/ or physiolball) by keeping the abs under tension as they lengthen. Reverse the direction by slowing contracting the abs (concentrically) and return to the starting position.

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5. Back Squat  (Eccentric emphasis/training tip).  Keeping the core tight, slowly (2 to 3 seconds) lower your body until the thighs are parallel to the ground. While looking straight ahead, keep the lower back slightly arched, with your heels down. When the parallel or “seated position” is reached, reverse the direction.

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