Eccentric exercise in the prevention of patellofemoral pain in high-volume runners: a rationale for integration

Review written by Tom Goom info

Key Points

  1. Eccentric training may help match the capacity of the muscles with the demands of running to help in the prevention of patellofemoral pain (PFP).
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Patellofemoral pain (PFP) is very common in runners and many patients can have lasting symptoms, even after treatment. In an ideal world we would have strategies to prevent PFP development, but quality studies in this area are lacking. Strength training is a promising approach with evidence suggesting it may reduce injury risk across a range of sports (1).

Eccentric training is a form of strength training that has been used successfully in tendinopathy and may have a role in PFP. This commentary paper explored this role and discussed the potential benefits of eccentric training and evidence that it may help prevent injury. My review of this paper focuses on some of the key points the paper makes, limitations to be aware of, and clinical implications.

Eccentric training has been used successfully in tendinopathy and may have a role in patellofemoral pain.
At present the best approach clinically is likely to be one that’s based on assessment and individual need.


One approach to treating and preventing injuries in athletes is the demand-capacity model. The authors use this model to underpin their reasoning, stating that, “In the simplest terms, overuse conditions develop when tissue capacity is exceeded by the activity demand”.

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