title: Isometric Contractions Are More Analgesic Than Isotonic Contractions for Patellar Tendon Pain: An In-Season Randomized Clinical Trial.
abstract: OBJECTIVE
  This study aimed to compare the immediate analgesic effects of 2 resistance programs in in-season athletes with patellar tendinopathy (PT). Resistance training is noninvasive, a principle stimulus for corticospinal and neuromuscular adaptation, and may be analgesic.
  
  
  METHODS
  Within-season randomized clinical trial. Data analysis was conducted blinded to group.
  
  
  METHODS
  Subelite volleyball and basketball competitions.
  
  
  METHODS
  Twenty jumping athletes aged more than 16 years, participating in games/trainings 3 times per week with clinically diagnosed PT.
  
  
  METHODS
  Two quadriceps resistance protocols were compared; (1) isometric leg extension holds at 60 degrees knee flexion (80% of their maximal voluntary isometric contraction) or (2) isotonic leg extension (at 80% of their 8 repetition maximum) 4 times per week for 4 weeks. Time under load and rest between sets was matched between groups.
  
  
  METHODS
  (1) Pain (0-10 numerical rating score) during single leg decline squat (SLDS), measured preintervention and postintervention sessions. (2) VISA-P, a questionnaire about tendon pain and function, completed at baseline and after 4 weeks.
  
  
  RESULTS
  Twenty athletes with PT (18 men, mean 22.5 ± 4.7 years) participated (isotonic n = 10, isometric n = 10). Baseline median SLDS pain was 5/10 for both groups (isotonic range 1-8, isometric range 2-8). Isometric contractions produced significantly greater immediate analgesia (P < 0.002). Week one analgesic response positively correlated with improvements in VISA-P at 4 weeks (r = 0.64).
  
  
  CONCLUSIONS
  Both protocols appear efficacious for in-season athletes to reduce pain, however, isometric contractions demonstrated significantly greater immediate analgesia throughout the 4-week trial. Greater analgesia may increase the ability to load or perform.
authors: *Department of Physiotherapy, Monash University, Victoria, Australia; †Australian Centre for Research into Injury in Sport and its Prevention, La Trobe University Bundoora, Victoria, Australia; ‡University of Groningen, University Medical Center Groningen, Groningen, Netherlands; §University of South Australia and PainAdelaide; ¶College of Science, Health and Engineering, School of Allied Health, Department of Rehabilitation, Nutrition and Sport, La Trobe Sport and Exercise Medicine Research Centre, La Trobe University, Bundoora, Australia; and ‖Faculty of Health, University of Canberra Research Institute for Sport and Exercise.
authors: Ebonie
authors: E
authors: Rio
authors: Mathijs
authors: M
authors: van Ark
authors: Sean
authors: S
authors: Docking
authors: G Lorimer
authors: GL
authors: Moseley
authors: Dawson
authors: D
authors: Kidgell
authors: Jamie E
authors: JE
authors: Gaida
authors: Inge
authors: I
authors: van den Akker-Scheek
authors: Johannes
authors: J
authors: Zwerver
authors: Jill
authors: J
authors: Cook
mesh_terms: D000293:Adolescent; D000328:Adult; D056352:Athletes; D001490:Basketball; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D007551:Isotonic Contraction; D008297:Male; D059408:Pain Management / Q000379:methods*; D010329:Patella / Q000503:physiopathology; D052097:Quadriceps Muscle; D055070:Resistance Training; D052256:Tendinopathy / Q000534:rehabilitation*; D054798:Volleyball; D055815:Young Adult