ABSTRACT
Background: Patellar tendinopathy is a common overuse condition characterised by load-related pain at the inferior pole of the patella and reduced function, particularly in athletes exposed to frequent jumping, landing and rapid changes of direction. In clinical practice, isometric exercise is frequently used within load-based rehabilitation because it may provide short-term hypoalgesia. Purpose: The aim of this thesis was to analyse the effectiveness of isometric exercise in reducing pain in people with patellar tendinopathy based on a literature review. Methods: Literature was searched in PubMed and Google Scholar using combinations of keywords related to patellar tendinopathy and isometric exercise. We included randomised clinical trials and prospective interventional studies that assessed the effect of isometric exercise on pain in individuals with patellar tendinopathy. Results: Seven studies with a total of 125 participants were included, mostly physically active males. The studies differed in design, intervention duration, exercise protocols and participant characteristics. The immediate hypoalgesic effect of isometric exercise was inconsistent across studies. In some studies, pain decreased substantially after the isometric protocol, in one study from 7.0 to 0.17 (p = 0.004), with the effect sustained for 45 minutes after exercise, while in some other studies the reduction was smaller or not statistically significant. In four-week programmes, all included studies reported a reduction in pain, however isometric exercise did not consistently demonstrate greater effectiveness compared to isotonic or dynamic exercise. Discussion and Conclusion: Isometric exercise may be useful primarily as a strategy for short-term pain management and creating short-term hypoalgesia, particularly during the competitive season or when isotonic exercise cannot be performed or is contraindicated. For long-term pain and functional improvement, a progressive loading programme that gradually increases mechanical demands is required. The effects of isometric exercise are not universal and depend on the protocol, timing of outcome assessment and individual characteristics. Further research with larger samples and standardised programmes is needed.
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