Have you ever heard of eccentric loading? No – you’re not alone. It’s an essential component to gaining strength especially when it comes to treating Achilles Tendinopathy.
If you are familiar with the term, then I imagine that you have spent some time weight training at the gym, am I right? In resistance training, it’s often called “negatives”.
This blog looks further at Eccentric loading and its role in Achilles tendinopathy treatment. Could it be the magic ingredient we need to treat this tricky problem?
Let’s find out.
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What is Eccentric loading?
Eccentric loading involves the lengthening of the muscles and tendons while a load is applied.
Have you ever done a push-up? The eccentric component to this is the lowering phase when your pectoral and tricep muscles are lengthening under a load of your body weight.
What about Concentric or Isometric loading?
Try this to demonstrate the types of loading…
It is important that your tendon can deal with all the loads applied to it; Eccentric, Concentric and Isometric are the main ones. Try this to better understand these 3 types of load.
Grab yourself a small object you can easily hold and lift without strain – this is your load.
Holding your load, bend your elbow – your biceps muscle and tendon fibres are shortening, this is a concentric contraction.
If we hold the object still this is an isometric contraction as no movement occurs.
Next, lower the object back to the starting position. This is the eccentric section of the movement, where the muscle and tendon fibers are lengthening before returning to the start position.
Benefits of Eccentric loading in Tendonitis.
Eccentric movements place a greater load on a tendon than concentric (shortening) movements. This allows the tendon to remodel and strengthen faster and more effectively than other types of loading.
Eccentric exercises are less demanding to the body than concentric exercises so your sore Achilles tendon can tolerate these exercises much better than other types of loading.
So you can see eccentric loading is a great tool, especially in the early stages when the tendon is reactive and one recommended by the National Institute of Clinical Excellence (NICE) in the treatment of Achilles Tendinopathy.
So maybe it is the magic ingredient?
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Unfortunately, it’s not that simple.
I would love to tell you that if you go away and do an eccentric loading program your tendon health will improve and your pain will go – but my clinical experience tells me it’s not – sorry!
Many people who see me in the clinic have already been online and have done an eccentric loading program but still have pain.
While I agree that eccentric loading is one of the main ingredients it is not the only one. There are so many other ingredients to include:
The fact that most loading programs focus only on gastrocnemius when the soleus muscle deals with almost 3x a load of gastrocnemius when running.
Eccentric loading is only one of the ways we load our tendon – what about all the others (and it’s not just the 3 mentioned above) It’s important to rehab the tendon to manage all the loads that it needs to deal with especially when returning to sport.
Foot position, muscle length, training schedule, strength around your core and pelvis, and weight … to name a few.
These components all need identifying and addressing in my experience to fully resolve the problem.
You can’t make a meal with just one ingredient
While I agree that eccentric loading is one of the main ingredients it is not the only one. There are so many more that need to be included:
Foot position, muscle length, training schedule, strength around your core and pelvis, and weight … to name a few.
Most loading programs focus only on Gastrocenimius, leaving out the more important Soleus muscle – which deals with almost 3x more load when running than gastrox.
Eccentric loading is only one of the ways we load our tendon – what about all the others (and it’s not just the 3 mentioned above)? It’s important to rehab the tendon to manage ALL the loads that it needs to deal with especially when returning to sport.
So it’s going to take much more than just one ingredient to make this meal.
Don’t worry I’ve got it all prepared for you, the ingredients, the recipe, the timings … we are talking 5 Michelin Stars here!
In my online Achilles Tendinopathy Program we look at all the factors that impact your tendon. I help you to identify them before going on to resolve them. This is coupled with a loading program incorporating eccentric loading as well as all the other loads as well as exercises for any other issues you may have identified during the biomechanics assessment. Everything you need to resolve this problem is all in one place and you can start straight away – no need to wait for an appointment to see someone.
Conclusion
Eccentric loading is a great tool for returning your tendon to good health. Allowing us to build greater strength while placing fewer demands on the tendon. A great tool I would agree. However, to get results it’s important not to focus solely on this tool. Having looked at some of those components you can see that there is so much more than eccentric loading needed for success. My online Achilles Tendinopathy Program covers ALL the elements needed to quickly and effectively treat this limiting problem.
You will soon be back up and running.
Take care, Helen
Helen Manders BSc Physiotherapy (Hons), MCSP, HCPC.
Chartered Physiotherapist Since 2001
P.S. Join me in my FREE MASTER CLASS learn about your tendon and find out if you have Achilles Tendinopathy/ Tendonitis?
