The intensity and frequency of resistance training influences the efficacy of tendinopathy management

1. In this systematic review and meta-analysis, it was found that higher intensities and lower frequencies of resistance training best facilitated recovery in the management of tendinopathy.

2. However, there was limited and inconsistent evidence regarding the role of resistance exercise volume on tendinopathy management.

Evidence Rating Level: 1 (Excellent)

Tendinopathy is a complicated chronic illness that involves the breakdown of tendons and is quite painful for affected patients. Exercise therapy is an important component of managing tendinopathy, particularly resistance training. Currently, there is a lack of studies investigating the dose-response relationship of resistance training in these patients. As a result, the objective of the present study was to investigate resistance training dose components, including intensity, volume, and frequency, in the management of tendinopathy.

Of 12,379 identified records, 110 (n=3953 participants) studies were included from various databases from 1998-2022. Studies were included if they evaluated the effects of a minimum of 2 of the 3 dose components for resistance exercise on tendinopathy management. Studies were excluded if patients experienced full thickness or large tendon tears or if the studies were conducted in countries that were not ranked ‘very high’ on the Human Development Index list. The review was performed using PRISMA guidelines. Statistical analysis was performed using meta-regression. The risk of bias was assessed using the Cochrane risk of bias (RoB) tool. The primary outcome was tendinopathy improvement.

The results demonstrated that there were greater effect sizes for higher intensity exercise regimens and those that used external loads, rather than body mass only. Additionally, it was found that frequencies of less than once per day were more likely to enhance recovery than more frequent regimens. However, the impact of exercise volume (sets and repetitions) did not produce consistent results. Despite these findings, the study was limited by lower rates of reporting for exercise intensity in comparison to volume and frequency, which may have influenced the results. Nonetheless, the present study added additional understanding of the role of resistance training in tendinopathy management.

Click to read the study in British Journal of Sports Medicine

Image: PD

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