Table 2

Characteristics of included studies

Study ID	Type of study	Participants’ characteristics	Interventions	Outcomes
AI, anti-inflammatories; a/a, as above; C, control; CE, concentric exercise; DASH, disabilities of the arm, shoulder and hand; DOS, duration of symptoms; EE, eccentric exercise; F, frictions; FAOS, foot and ankle outcome score; RCT, randomised controlled trial; Sp, splint; St, stretching; US, ultrasound; VAS, visual analogue scale; VISA, Victorian Institute of Sport Assessment.
Cannell 2001⁵⁷	RCT	Participants: 19 subjects involved in various sports.	Ice, AIs and rest for the first two weeks of the study; then 12-week intervention.	Length of follow-up: no follow-up past intervention
	Method of randomisation: sealed envelope draw.	EE = 10: 7 male, 3 female, Age = 26 (23–29) years, DOS = 3.1 (1.6–4.6) mths.	EE group: 3 sets of 20 drop-squats 1/day, 5 days/week. Load increase over 4 levels and dependent on body weight. Activity level could increase over this period.	Outcomes assessed:
	2 groups: drop-squats (EE) or leg extension/curl exercises (CE).	CE = 9: 6 male, 3 female, Age = 26 (19–33) years, DOS = 4.2 (2.3–6.1) mths.	CE group: 3 sets of 10 lifts of each exercise, 1/day, 5 days/week. Weights increased as per table over 4 levels. Activity increased over this period as able.	Pain: VAS
				Return to sport: reported at the 12-week stage –y/n
				Muscle strength: quads and hamstrings moments of force 30°/sec on both legs.
Jonsson 2005⁴⁵	RCT	Participants: 15 patients active in various sports.	12-week intervention.	Length of follow-up: 32.6 months.
	Method of randomisation: not stated.	EE = 10: 7 male, 1 female. Age = 25.7±9.9 years, DOS = 15.4±6 mths.	No sports-specific training for 6 weeks. Given by same physiotherapist. Both groups performed exercise on decline board. Training was meant to be painful. Load increased to attain this.	Outcomes assessed:
	2 groups: EE and CE.	CE = 9: 6 male, 1 female, Age = 24.1±6.1 years, DOS = 19.6±20.3 mths.	EE group: exercises done 2 times a day, 7 days/week. 3×15 reps. Concentric activity done by uninjured leg.	Pain: VAS
			CE group: a/a, eccentric activity avoided as much as possible.	Function: VISA score for knee function.
				Patient satisfaction: satisfied/not satisfied.
Mafi 2001²⁷	RCT	Participants: 44 patients referred as potential surgical candidates: 24 male, 20 female.	12-week intervention.	Length of follow-up: no follow-up past intervention.
	Method of randomisation: envelope.	EE = 22, Age = 48.1±9.5 years, DOS = 18 (3–120) mths.	EE group: exercises done 2 times a day, 7 days/week. Two exercises used short and long calf muscle loading. Each 3×15 reps. Concentric activity done by uninjured leg. Increased load when exercise became pain free.	Outcomes assessed:
	2 groups: EE and CE.	CE = 22, Age = 48.4±8.3 years, DOS = 23 (5–120) mths.	CE group: various concentric exercises used, from calf raises to side jumps.	Pain: VAS
				Patient satisfaction: satisfied/not satisfied.
Martinez-Silvestrini 2005⁴⁶	RCT	Participants: 94 subjects: 50 male, 44 female.	6-week intervention.	Length of follow-up: no follow-up past intervention.
	Method of randomisation: not stated.	DOS: >3 mths.	Stretching group: 2 times/day 3 repetitions held for 30 secs, 30 sec rest between.	Outcomes assessed:
	3 groups: stretching, EE + stretching, CE + stretching.	Age:	EE group: eccentric resistance band exercises, avoiding concentric activity. 3 sets of 10 reps 1 time/day 2, 5 minutes of rest between sets.	Grip strength: pain free.
		St = 43.1 years.	CE group: a/a but eccentric load avoided during exercise.	Patient-rated forearm evaluation questionnaire.
		EE + St = 46.6 years.	Advice on ice massage and strap use was also given to all patients.	DASH
		CE + St = 47.0 years.		SF–36.
				Pain: VAS
				Patient satisfaction: 5 point scale.
Neisen-Vertommen 1992⁵⁹	RCT.	Participants: 17 non-competitive recreational athletes	12-week intervention.	Length of follow-up: no follow-up past intervention.
	Method of randomisation: not stated.	EE = 8	5 sets of 10 reps, in a pain free ROM, 1 time/day 6/week.	Outcomes assessed:
	2 groups: EE and CE.	4 male, Age = 39.5±3.2 years, DOS: 3.7±1.1 mths.
		4 female, Age = 31±2.6 years, DOS: 3.7±0.9 mths.	EE group: protocol outlined in another journal article, raised step exercise, eccentric only.	Concentric and eccentric plantarflexor average and peak torque, 30°/sec and 50°/sec.
		CE = 9	CE group: progressive concentric exercise programme on universal gym.	Pain: scale from 1–10.
		6 male, Age = 37.33±1.7	Each group progressed weight as able.
		3 female, Age = 28.66±3.2 years.		Return to activity: scale from 1–10; 10 denoted full activity of pre-injured level.
Roos 2004⁵⁰	RCT.	Participants: 44: 21 male, 23 female. Age = mean 45 years. DOS: 5.5 (1–180) mths.	12-week intervention.	Length of follow-up: 1 year.
	Method of randomisation: envelope.
		EE = 16	EE group: as described by Alfredson et al 1998. Straight and bend knee exercises. Day 1–2 1×15; day 3–4 2×15; day 5–7 3×15; then 3×15 from then on. Load added as tolerated.	Outcomes assessed:
	3 groups: EE, night splint or combination of both.	EE + Sp = 15	Night splint group: anterior night splint, night-time use only.	FAOS
		Sp = 13	Combination group: a/a.	Return to sport: y/n.
Selvanetti 2003⁶³	RCT	Participants: 60 patients.	20–30 sessions.	Length of follow-up: mean 11 months.
	Method of randomisation: envelope numbered and sealed.	EE = 31: 17 males, 14 female, Age = 41.3 (33–54) years, DOS = 6.6 (2–10) mths.	EE group: 3 mins warm-up, 4 PNF contract relax (10 sec contract, 2 sec rest, 30 sec stretch), 3 sets of 10 reps ecc. Exercises with theraband, 30 secs rest between sets, PNF stretches times 4 again then ice for 15 minutes.	Outcomes assessed:
	2 groups: sham ultrasound and counselling, and EE, contract-relax stretching and counselling.	US = 29: 15 males, 14 female, Age = 40.5 (32–52) years, DOS = 6.8 (3–11) mths.	US group: placebo US (20 sessions, 5/week).	Pain: VAS scale, but 0 = severe, 10 = no pain.
				Patient satisfaction: subjective general enhancement; 0–100%
Silbernagel 2001⁵²	RCT.	Participants: 40 (57 involved tendons) patients.	12-week intervention.	Length of follow-up: 6 months.
		EE = 30 tendons, 17 male, 5 female, Age = 47±14.7 years, DOS = 20±25.4 mths.		One-year follow-up for summary of questions to patient.
	Method of randomisation: not stated.		EE group: extensive exercise programme split into 3 phases, including ROM exercises, concentric exercises and eccentric exercises. Pain allowed to reach 5 on VAS, no morning stiffness following, and decrease in VAS pain by morning.
	2 groups: EE and CE.	CE = 27 tendons, 14 male, 4 female, Age = 41±10.2 years, DOS = 41±55.9 mths.	CE group: a/a minus the eccentric exercises. Frequency of all exercises in all groups varied from week to week.	Outcomes assessed:
				Pain: VAS
				Function: plantarflexion, jumping test, toe raising test.
				Patient satisfaction: y/n.
Stasinopoulos 2004⁵³	RCT.	Participants: 30 patients, DOS = minimum 3 mths.	4-week intervention.	Length of follow-up: 3 months.
	Method of randomisation: drawing lots.	EE = 10: 7 male, 3 female, Age = 28.12±2.03 years.	All patients received 3 treatments per week.	Outcomes assessed:
	3 groups: EE, pulsed US, and frictions (F).	US = 10: 6 males, 4 female, Age = 29.17±3.76 years.	EE group: static stretching exercises, 3 sets of 15 unilateral eccentric squats, load increased as able, 2 minute rest between sets.	Pain status: worse, no change, somewhat better, much better, no pain.
		F = 10: 5 male, 5 female, Age = 26.24±4.17 years.	US group: local pulsed US 0.4–0.8 W/cm² ratio1:4, 2 ms pulse duration, frequency 1 MHz. -10 minutes.
			Friction group: Cyriax and Cyriax technique for 10 minutes.
Svernlov 2001⁵⁴	RCT.	Participants: pilot study: 30 patients.	12-week intervention.	Length of follow-up: 12 months for pilot, after 3 months training in clinical study.
	Method of randomisation: not stated.	EE = 15: 13 male, 2 female, Age = 42.1 years, DOS = 10.7 (3–24) mths.	EE group: warm-up ex. 2–3 mins, static stretch 3–5 times (15–30 secs), eccentric exercises, 3 sets of 5 with dumb-bell 10 sec duration, static stretch as before, performed 1 time/day.	Outcomes assessed:
	2 groups: EE and St. Both with use of brace.	St = 15: 6 male, 9 female, Age = 43 years, DOS = 8.4 (3–20) mths.	Stretching group: 10 secs of contractions of muscle, relaxation 2 secs, stretching 15–20 secs, repeated 3–5 times twice daily.	Pain: VAS
				Strength testing: using strain gauge device.
				Patient satisfaction: y/n.
Visnes 2005⁵⁵	RCT.	Participants: 29 male and female elite volleyball players (12 with bilateral symptoms) in Norway.	12-week intervention.	Length of Follow-up: 6 months after end of intervention.
	Method of randomisation: by statistician who was blinded to player identity.	EE = 13: 8 male, 5 female, Age = 26.8±4.6 years, DOS = 67±44 mths	EE group: twice daily, 3 sets of 15 reps, done without warming up. Decline squat exercise, eccentric loading only on affected leg, recommended to have 5/10 pain upon exercising. Load was increased as pain decreased.	Outcomes assessed:
	2 groups: EE and control.	C = 16: 11 male, 5 female, Age = 26.4±3.4 years, DOS = 79±75 mths.	Control group: no intervention, trained as usual.	Function: VISA scores for knee function.
				Global evaluation score (pain and function) and jumping performance.