Eccentric Strengthening Exercises for Wrist Tendinosis
Eccentric strengthening exercises are the recommended treatment for wrist tendinosis as they reduce symptoms, increase strength, and promote tendon healing. 1
Understanding Wrist Tendinosis
Wrist tendinosis is a degenerative condition of the wrist tendons characterized by:
- Pain with activity and focal tenderness 2
- Decreased ability to tolerate tension 2
- Disorganized collagen fibers rather than inflammation 3
- Common in activities requiring repetitive wrist movements 3
Recommended Eccentric Exercises
Basic Eccentric Wrist Extension Exercise
- Using a rubber bar or light dumbbell 4
- Start with wrist in full extension (bent backward) 4
- Slowly lower the weight (3-5 seconds) while allowing wrist to flex forward 1, 4
- Use opposite hand to return to starting position (avoiding concentric phase) 4
- Perform 3 sets of 10-15 repetitions, 2-3 times per week 1
Progressive Loading Protocol
- Begin with low resistance that allows 10-15 repetitions without significant pain 1
- Gradually increase resistance as symptoms improve 1
- Perform exercises at moderate to slow controlled speed 1
- Maintain full range of motion during exercises 1
- Exhale during the eccentric (lowering) phase 1
Implementation Guidelines
Exercise Parameters
- Frequency: 2-3 non-consecutive days per week 1
- Duration: 3 seconds for eccentric phase 1
- Sets/Repetitions: Start with 1 set of 10-15 repetitions, progress to 3 sets 1
- Pain level: Mild discomfort is acceptable during exercise, but pain should not persist after exercise 1
Complementary Treatments
- Relative rest to prevent further damage 1
- Cryotherapy (ice through wet towel for 10 minutes) for pain relief 1
- Stretching of the wrist extensor muscles 1
Important Considerations
- Avoid complete immobilization as it can lead to muscle atrophy and deconditioning 1
- Tensile loading of the tendon stimulates collagen production and guides normal alignment of newly formed collagen fibers 1
- Consistency is crucial - benefits typically require 6-12 weeks of regular exercise 2
- Monitor for increased pain - exercises should not significantly worsen symptoms 1
Evidence and Limitations
- While eccentric exercises have shown good results for Achilles and patellar tendinopathies, evidence specifically for wrist tendinosis is more limited 5
- One study showed that adding eccentric wrist extensor exercise to standard treatment significantly improved outcomes (76% improvement in function vs 13% with standard treatment alone) 4
- The optimal dosage parameters (frequency, intensity, duration) are still being researched 5, 6
- Exercise therapy is often most effective when combined with other treatments rather than used in isolation 5
Common Pitfalls to Avoid
- Progressing too quickly - increase resistance only when exercises can be performed with minimal pain 1
- Performing exercises incorrectly - focus on slow, controlled eccentric phase 1
- Inconsistent practice - regular performance is necessary for tissue adaptation 2
- Ignoring pain - sharp or severe pain during exercise indicates need to reduce load 1
By following these eccentric strengthening guidelines, patients with wrist tendinosis can expect gradual improvement in pain and function over several weeks to months 4.