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Can eccentric cycling be used to treat patellar tendinopathy?
  1. Joel A Walsh1,
  2. Sophie Bos2,
  3. Darryl J McAndrew3,
  4. Paul J Stapley1
  1. 1 Faculty of Science, Medicine and Health, University of Wollongong School of Medical Indigenous and Health Sciences, Wollongong, New South Wales, Australia
  2. 2 Independent Occupational Therapy, University of Wollongong—Innovation Campus, North Wollongong, New South Wales, Australia
  3. 3 Faculty of Science, Medicine and Health, University of Wollongong Graduate School of Medicine, Wollongong, New South Wales, Australia
  1. Correspondence to Prof Paul J Stapley, Faculty of Science, Medicine and Health, University of Wollongong, School of Medical Indigenous and Health Sciences, Wollongong, New South Wales 2522, Australia; pstapley{at}

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Eccentric exercise (EE) is a primary evidence-based intervention for treating patellar tendinopathy (PT).1 Specifically, EEs (ie, decline squats, drop squats) are typically prescribed for patients with PT to alleviate pain and dysfunction associated with mechanical loading of the patellar tendon.1 2 While successful, current EE protocols are considered time-consuming and require highly motivated patients.3 Here, we propose that eccentric cycling (EC) may be a novel approach to treating PT and could address certain limitations associated with current EE protocols.

Current practice using eccentric exercise protocols

Current EE protocols (see online supplemental material (a)) appear to alleviate PT symptoms, including pain, by providing a strong remodelling stimulus to the lengthening musculotendinous unit.3 However (see online supplemental material (b)), they have limited capacity to gradually tailor the prescribed workload (ie, progress velocity, load and duration), during PT rehabilitation, which may restrict positive adaptations.3 4 Furthermore, the time-consuming and repetitive nature of current EE protocols, which often leads to issues with adherence to treatment plans and overall recovery success, may necessitate the adoption of alternative EE modalities.3 EC provides a model of EE that may enable a close monitoring and gradual progression of workload that targets the muscle groups implicated in PT. …

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  • Contributors JW and PJS compiled the article. All authors were involved in the conceptualisation, revising and approval of the article, prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.