CRITICALLY EVALUATE THE BIOLOGICAL PLAUSIBILITY FOR THE APPLICATION OF ECCENTRIC LOADING EXERCISES IN THE MANAGEMENT OF PATELLAR TENDINOPATHY

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Critically Evaluate the Biological Plausibility for the Application of Eccentric Loading Exercises in the Management of Patellar Tendinopathy

Introduction

Tendinopathies, especially patellar tendinopathy, is popular among athletes, including elite and recreational, forcing them to experience disability lasting for an extended period. Patellar tendinopathy denotes a musculoskeletal condition that commonly affects sportspersons training and competing at different standards. Physiologists use eccentric contraction or negative work to manage this disorder since it is an exercise that involves moving an active muscle that is under stress from a load through a repeated contraction of lengthening of affected muscles. It is a phenomenon that creates braking power that directly opposes the shortening of a muscle. For example, lowering an arm in a biceps curl, generates an eccentric motion while the lifting of a weight is concentric. Negative training manages patellar tendinopathy as they let muscles absorb mechanical energy applied by a large force; subsequently, producing an elastic recoil that eases movement in muscles. For these reasons, eccentric loading creates significant force with less energy, reducing strain on injured joints and muscles.

Part One

Overview of Eccentric Loading Exercises in the Management of Patellar Tendinopathy

The Physiology of a Healthy Patellar Tendon

A healthy patellar tendon has quadriceps femoris that converge onto the shinbone. Rio, Kidgell, Purdam, Gaida, Moseley, Pearce, and Cook (2015) explain that it covers the knee, and one of its headed muscles flexes the hip. As a sesamoid bone, the patella tendon is four-headed and links the tip of the kneecap to the tibial tuberosity, improving how it pulls the tibia (Rudavsky, & Cook, 2014). All of this shows that a patellar tendon is a fibrous tissue that connects two bones; for example, it links the kneecap and the tibia. The 5-centimeter-long patella ligament has lateral and medial parts that descend on either side of the kneecap and slots in the tibia's upper frontal surface. According to Malliaras, Cook, Purdam, and Rio (2015), the patellar tendon converges into a continuous capsule, forming the patellar retinacula. A synovial membrane and an infrapatellar fat pad separate the posterior parts of the patellar tendon from the knee joint, while an infrapatellar bursa delinks it from the shinbone. Therefore, the patellar ligament enhances the flexibility of the leg at the knee joint and ensures the kneecap is in position.

The Physiology of an Injured Tendon

An injured patellar tendon can either have partial or complete tears, resulting from unexpected tightening of quadriceps against resistance. According to Dragoo, Wasterlain, Braun, and Nead (2014), partial tears do not affect soft tissues extensively, whereas complete ones will separate the connective muscles into two. As a consequence, a ruptured patellar tendon pushes the kneecap upwards towards the quadriceps femoris. In their study, Liddle, and Rodríguez-Merchán (2015) postulate that if a patella tendon has a complete tear, then the four-headed muscles separate from the kneecap. A complete rupture denies the kneecap support from the shinbone, moving towards the hip, following the contraction of quadriceps muscles; consequently, preventing the leg from extending. Malliaras et al. (2015) trust that this results in those affected failing to stand as the knee buckles when upon exertion of power. The patellar tendon is vulnerable at the point it connects with the kneecap; hence, a bone can break and damage the ligament either partially or entirely. All of this indicates that when a strong force affects the knee, the possibility of a tear...