Efetividade do fortalecimento excêntrico sobre a dor, perda de função e retorno ao esporte no tratamento da tendinopatia patelar e de aquiles em atletas

Abstract

The etiology of tendinopathies is still obscure, presenting two hypotheses in the literature about tendon injury: a mechanical theory, linked to repetitive microtraumatism, and a vascular theory associated with reduced vascular perfusion in the tendons. Patellar and Achilles Tendinopathy are well known for being difficult to treat and may even finish with the athlete's career. Conservative treatment is often used to relieve symptoms and surgery is needed about 25% of cases. Eccentric strengthening seems to be important for successful rehabilitation. Thus, the objective of this review was to identify the best treatment strategies for Patellar Tendinopathy and Achilles in athletes using eccentric exercises in order to minimize pain and loss of function maximizing return to sports. We searched LILACS, PubMED, SCIELO, BIREME, COCHRANE and EMBASE databases including clinical trials, in the Portuguese and English languages, with date until February 2017. The descriptors used were Eccentric Exercise and Patellar Tendinopathy and athletes and Eccentric exercise and Achilles tendinopathy and athletes and 8 articles was used out of 108 matching. In athletes with Patellar and Achilles Tendinopathy, studies demonstrated a severe improvement of symptoms, pain and loss of function after an eccentric exercise with a 12-week intervention of inclined eccentric squatting exercises. Most athletes returned to their levels of pre-injury sports activity after training. In this review, all selected studies have demonstrated the therapeutic success of using eccentric training demonstrating that it is a safe, easy to execute and understand and convenient training model with no risk of new injuries, allowing its implementation as an exercise in most of the athletes training program