The effect of decline loading on Patellar Tendinopathy in rugby union players
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Objective: The objective of this study was to investigate the effect of an Eccentric Decline Squat (EDS) programme in a rugby player population with Patellar Tendinopathy. It was hypothesized that implementing an EDS programme of 12 weeks duration, with this target population, will give improved VISA-P (Victorian Institute of Sport Assessment) outcome results than a standard treatment regime. Study Design: An interventional study design was used, comparing the effectiveness of an EDS programme to alternate treatment regime in 28 rugby union players, who continued to train and play. Background: Patellar tendinopathy is a common condition in athletes, and often difficult to resolve. Several recent studies have shown promising clinical results using single-leg eccentric squat training on a 25 degree decline board to treat patellar tendinopathy. There have been no such studies on a rugby union population. The purpose of this study was to assess the effectiveness of the EDS programme in rugby players with patellar tendinopathy, and compare that with treatment regimes that did not include eccentric decline squats. Method: Change in pain and function were recorded weekly for each group, using VISA-P scoring. The intervention group performed EDS programme on a 25 degree decline board, twice daily (3 sets of 15 reps), 6 days / week, for 12 weeks. The control group followed a treatment regime prescribed by their physiotherapist, for 12 weeks. Their regime did not include eccentric decline squats as part of the management. Players in both groups continued to train and play rugby throughout the intervention period. Results: Following the intervention period there was a significant (p=.000) improvement in VISA-P scores for the intervention group from the baseline to the 12 week mark, 65.75 points (SD 9.08) to 94.5 points (SD 10.02). No significant differences (p=.900) were observed in the control group with regard VISA-P scores, 66.75 (SD 15.49) to 81 points (SD 18.33). Conclusion: This is one of the first research studies looking at an EDS programme in a rugby population. The results in this study showed EDS offered greater gains than other standard care treatment options over a 12 week period. The results of this study will support, and recommend, future use of EDS in a rugby population with this injury. Further studies involving greater numbers and comparing EDS to other treatment programmes, as in this study, may add weight to these findings.