Isometric exercises involve a partial muscle contraction without fully changing the muscle length or the angle of the joint. Basically, along with an isometric exercise, you are holding a position against resistance.

Why isometric exercises?

Most recent studies demonstrate how isometric exercises are crucial to exercise rehabilitation. Indeed, this type of exercise is ideal for starting a recovery program post-injury or even for improving a chronic pain presentation. Thanks to the muscle’s partial contraction, we activate positive neuromuscular adaptations of the tissue, avoiding leading the central nervous system into a fight-or-flight mode to protect the body from pain signals.

Indeed, Isometric exercises, along the rehabilitation process, aim to desensitize the area affected.

Injury recovery.

To simplify the explanation, think of a grade 2 torn muscle. This type of injury refers to a muscle that has a hall in it. If we fully contract the muscle with concentric exercises, it would require all fibre to work really hard, and it would also require the fibre to be fully contracted. This would lead to pain and risk of further injury, as the muscle is not fully operative due to a hall. On the other hand, if doing a partial contraction of the muscle fibre, even the smallest one, and by holding it, we are still engaging the muscle, we are still activating it, and we are keeping our alarm system controlled by the central nervous system off. Furthermore, the activation of the muscle, even if partial, would still stimulate blood flow in the area, enough at least to stimulate a further recovery process.

Would tendons benefit from isometric exercises?

Yes they would, and let’s see how:

• During these exercises, tendons are subjected to tension without the additional strain of joint movement. A classic example is the recovery of a tendon from a tendinopathy, where the reduction in mechanical stress helps avoid exacerbating pain while still providing a stimulus for repair.
• Tendons would also benefit from this constant but controlled load to improve their strength, which would pay back in the future, leading to a decrease in injury due to sudden increasing load or repetitive movement.
• Given the composition of tendons, as per fibres made of collagen, isometric exercises stimulate collagen synthesis and deposition, which is essential for tendon repair and remodelling.

What are some examples of Isometric Exercises?

• Isometric Hamstring Curl: This exercise is ideal for hamstring tendinopathy.1. Start by lying on your back with your knees bent.
  2. Next, start pressing your heels into the floor as hard as possible without moving your legs.
  3. Hold the press for 30 to 45 secs or as per directed by your physician.
• Isometric Calf Raise: Ideal for Achilles Tendinopathy.
  1. Stand on both feet and elevate the hill of the ground.
  2. Hold this position to engage the calf muscles and Achilles tendon.
• Isometric Shoulder External Rotation: To be used for rotator cuff tendinopathy.
  1. This exercise can be practised in a standing or sitting position. Start by holding a resistance band or towel against your abdomen with your elbow bent at 90 degrees.
  2. Press outward against a wall or an object that resist your force. This could also be a firm band that is attached to the opposite side of the pushing force.
  3. The force in this exercise can be also directed medially, as per internal rotation. This is done when the target are muscle/tendons that provide internal rotation, like subscapularis and teres major.

More complex forms of isometric exercises include plank, wall sit, push-up hold, bridge hold and bicep curl hold.

Isometric and progressions

Progression is essential to ensure body tissue’s ongoing stimulation and progress a potential recovery process. That said, progression has to be steady and applied slowly. To progress isometric exercises, we can increase the time of load from 30 to 45 seconds (per example) or increase the resistance/weight that the muscle or tendon is subjected to.

On the other hand, another form of progression can be passing from standing on two feet to standing on one foot only or by doing a plank with the knee down to a plank on feet.

During the recovery process from an injury, simple progression for isometric hold would take place in the second week after the injury. This applies to injuries like muscle tear, acute tendinopathy, or ankle sprain. At Melbourne Massage and Treatment, we offer a Treatment Plan that is a rehabilitation package for those who are recovering from an injury and need to progress their exercises along with ongoing hands-on treatment.

In conclusion, isometric exercises are ideal for an early stage of injury recovery, especially in the sport field, but can still be part of a more in depth type of training, aiming to improve tendon capacity and joint stability.

FAQ:

Q: What are isometric exercises?
A: Isometric exercises are those during which you contract your muscles without lengthening or changing the angle of the joint. In other words, you sustain a static position with some form of resistance, like holding a plank or pushing against a wall.

Q: How do isometric exercises benefit tendons?
A: Isometric exercises have a positive effect on tendons, as they reduce mechanical stress, enhance tolerance to load, improve collagen synthesis, modulate pain, enhance vascularization, and finally stimulate the cells. Therefore, isometric exercises can be used for rehabilitation and repair of tendons, pain relief, and strain relief.

Q: Does isometric exercise possess any potential for pain management in tendinopathy?
A: Isometric exercises may indeed be used to manage the pain arising from the pathology of tendinopathy. They can reduce pain by modulating pain perception, decreasing pain-evoking neural inputs, and improving local blood flow, which promotes the healing process.

Q: How should isometric exercises be integrated into a rehabilitation program for tendinopathy?
A: Isometric exercises should be cautiously added into a rehabilitation program, initially with low-intensity exercises and then gradually increasing in duration and intensity over time. This must be part of a package that also includes other modes of therapy, such as eccentric exercises, stretching, and functional training.

Q: Are isometric exercises possible for all those patients with tendinopathy?
A: Isometric exercises generally do not harm people with tendinopathy in large doses and are low-impact, joint-friendly exercises. However, a balance between specific tendon involvement and individual pain responses and rehabilitation stage should be done accordingly. Exercises should not be instituted without a consultation with a healthcare professional.