Abstract
BackgroundTendinopathies are specific degenerative conditions of the tendon characterized by pain and disability. The most common tendinopathies of the lower limbs are patellar, Achilles, gluteal, and proximal tendinopathy of the hamstring muscles. Exercise therapy has been studied for the treatment of these tendinopathies; however, different types of muscle contraction, exercise, dose, and intensity are found in the literature, which can make choosing the best treatment option difficult. The purpose of this systematic review is to analyze the available evidence about the effectiveness of exercise therapy in the treatment of patients with lower limb tendinopathies and the effects of different types of exercise therapy in the treatment of these patients.MethodsThe search strategy will be performed in the following databases: CENTRAL, MEDLINE, EMBASE, PEDro, SPORTDiscus, and CINAHL. The inclusion criteria of the studies will be randomized controlled trials with patients with one of the following tendinopathies: patellar, Achilles, gluteal, and proximal tendinopathy of the hamstring muscles. The primary outcomes will be pain and disability. The intervention will be exercise therapy, and the comparators will be different types of exercise, control groups, or any other type of intervention.DiscussionOther systematic reviews have been published about the prescription of exercise therapy in the treatment of tendinopathies of the lower limbs. However, the results of these reviews are limited to only one type of tendinopathy or specific exercise. Because some of these reviews are also outdated, this systematic review will investigate whether exercise therapy is more effective than any other type of intervention and if there is a best form of exercise therapy, considering modality, dose, and intensity, for the treatment of lower limb tendinopathies. Furthermore, this study will present data related to the sample size, recruitment period, methodological quality, and visibility of the eligible studies.Systematic review registrationPROSPERO (CRD42018093011)
Highlights
Tendinopathies are specific degenerative conditions of the tendon characterized by pain and disability
Proximal tendinopathy of the hamstring muscles still has an unknown prevalence, but the literature emphasizes that it is prevalent in sprinters [2, 16]
The current literature shows that strengthening exercises are effective for the treatment of patients with lower limb tendinopathies [30, 31, 36]
Summary
Tendinopathies are specific degenerative conditions of the tendon characterized by pain and disability. The most common tendinopathies of the lower limbs are patellar, Achilles, gluteal, and proximal tendinopathy of the hamstring muscles. Franco et al Systematic Reviews (2019) 8:142 mechanical conditions are associated with a much higher mechanical demand than the tendon can tolerate and are caused by movements such as jumping, landing, and abrupt change of direction, which are commonly adopted during lower limb sporting gestures [10, 11]. Among the common tendinopathies affecting the lower limbs, patellar tendinopathy is the most prevalent, especially in elite volleyball athletes [12], whose sporting gestures include jumping, landing, and constant direction change [12,13,14]. Gluteal tendinopathy is most prevalent in patients with a low level of physical activity and may be a result of the overload of the gluteus medius, gluteus maximus, or both [18, 19]
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