Effects of Eccentric Exercise Associated with Patellofemoral Tendinopathy: A Systematic Review

Background: Patellofemoral tendinopathy is a common condition that is associated with anteromedial knee pain due to chronicrepetitive tendon overloading. Physical therapy in combination with an eccentric exercise program has been thought to be the goldstandard of treatment for patellofemoral tendinopathy. The aim of this study was to examine the literature regarding theeffectiveness of treating patellofemoral tendinopathy with eccentric exercise and other interventions. Methods: A literature search of Medline Complete, PubMed, CINAHL Complete, and Journal of Science and Medicine in Sports was conducted using PEDro guidelines. Results: Eight articles met our selection criteria. The 8 articles investigated individuals who all had pain at the inferior pole of thepatella or were diagnosed via ultrasound for patellar tendinopathy. The articles investigated the effects of eccentric exercise versus other treatments such as, progressive tendon-loading exercise therapy (PTLE), extracorporeal shock wave therapy (ESWT),percutaneous electrolysis (PNE), dry needling (DN), and concentric hip muscle strengthening. Ultimately, each treatment resultedin decreased pain and patellar stiffness, along with improvement in outcome measures, but it was found that no intervention was more effective than eccentric exercise alone, besides progressive tendon-loading exercise therapy. Conclusions: Moderate to strong mixed evidence exists to show the effect of eccentric exercise in combination with otherinterventions decreases patellofemoral pain and increased functional mobility in individuals with patellofemoral tendinopathy. Progressive tendon-loading exercise therapy was the one treatment that showed more significant improvements in outcome measures compared to eccentric exercise therapy and requires further research to back this finding.