Prevent 45% of Soft-Tissue Injuries with Accentuated Eccentric Training

Preventing injuries is the key to success in the field of human performance. Your body’s tissues and bones require time to adapt to external loads which means putting the horse before the cart. Working hard and working smart are two key requisites to make it to your goals and aligning your life to reach those goals should account for recovery and regeneration of tissues.

In this article we will dive into the application of acceleration and deceleration specific training and how adjusting tempo for the desired goals can allow us to maximize our strength, muscle hypertrophy, fat loss, and most importantly injury prevention and tissue health.

Here’s What You Need To Know…

1. The greatest potential for increasing the longevity of your lifting career is maintaining safety by improving tissue resilience to injuries. This can be achieved by implementing and exposing the body to eccentric loads or decelerating tasks.

2. Eccentric training is what is recommended to rehabilitate dysfunctional scarred up tendons (tendinosis, tendinopathy), hence this form of training can also be used to regenerate tendon tissue and improve in tissue compliance/performance if an injury is what is keeping you away from a lift.

3. Implementing specific tempo protocols to a lifting program have been shown to bring out increased muscle strength, improved neuromuscular recruitment (mind-muscle connection), improved joint stability, increased muscle hypertrophy, and also induced fat loss by means of increased metabolism.

4. Here’s how to prioritize eccentric training into your programs in various different ways based on your goals, your training history and your current functional and injury status.

The Cold Hard Truth About Training Injuries

Every year in the U.S. alone, soft tissue injuries to tendons, ligaments, and joint capsules account for 45% of the over 32 million musculoskeletal injuries.

With what we know about these tissue types and their slow recovery rates coupled with the overwhelming increase in participation of recreational sports and weight lifting made popular by CrossFit and other social fitness clubs; more than ever, we need to establish some true injury prevention guidelines within the different areas of fitness to raise awareness of proper strength and conditioning of soft tissue.

Classical rehab protocols (ice pack, heat pack, E-stim, ultrasound, passive ROM) for torn shoulder rotator cuffs, to Achilles tendons and hand flexor tendons, are reported too often and fall short of what is being promised when compared to conservative models. These lack luster figures are a result of all-too-often conservative rehab approaches that are not aggressive enough with both education and optimal tissue loading.

So, we need to address this issue head on and add more specificity to our current training parameters in order to honestly improve tissue resilience to soft tissue injuries, and attempt to regenerate and prevent injuries all together if possible.

Recover At The Oxygen Bar?

You, I, and just about most living creatures on this planet use oxygen as a means of converting sugar into energy. It’s a perfect system, where the gas is recycled and the process is a closed loop. But with evolution at the wheel, adaptations for survival lead to changes in energy system utilization, so that we can now perform mechanical work without oxygen. This form of work is known as anaerobic work and it is predominately the energy source that our tendons, ligaments, and joint capsules use to carry loads and maintain tension for extended periods of time.

This form of energy requires very little to no oxygen in the process of converting chemical substrates into biomechanical motion. In fact, the typical oxygen consumption of tendons and ligaments is around 7.5 times lower than that of skeletal muscle. Which means tendons, ligaments, and joint capsules are often operational under prolonged ischemic (low oxygen) states. Hence, if bone, muscle, or nerve tissues were exposed to the same low oxygen environments that these specialized and adapted tissues are exposed to daily, the results would be tissue necrosis or simply stated tissue death.

It’s this low metabolic rate that is equally the downfall of these tissues when injured. And to add another stick in the spokes, tendon blood flow has been shown to decrease with increasing age; over 10 years of repeated mechanical loading.

Everything is finite. Hence, there is much to be said about recovery, but more to be thought about when considering prevention as a proactive means of conditioning these tissues and other various biological structures (bone, nerve, and circulatory system) to hold together and avoid injury all together.

RELATED: THE COMPLETE GUIDE TO TISSUE REGENERATION

In other words, we need to become more resilient to injury if we are to see what we do for health and wellness as a lifelong pursuit.

To Follow, Ot Not Follow The Fitness Fads

When we think of strength we often imagine a powerful pushing or pulling of an object of great weight, but rarely do we think of moving slowly or methodically, which is much less sexy.

Adaptations to any movement pattern take time, and when we attempt to move to quickly through them, we omit any mastery of the pattern and subject our tissues to overload or overuse.

Consider that the human skeleton takes, on average, 12-15 years to mature; one should not assume that even a year of training is really any sort of time for bones, and other various soft tissue to adapt. Sure muscle hypertrophy can occur and increases in nervous system muscle recruitment can occur, but the faster one pushes equally the early the onset of tissue failure will occur. Hence, it’s usually learning how to balance things out, and not over do the volume, that makes the difference.

The terms concentric and eccentric should be quite well known in today’s lifting communities but in laymen’s terms lets replace them respectively with acceleration and deceleration.

RELATED: KNOW YOUR CONTRACTIONS FOR BETTER TRAINING & PROGRAMMING

Let’s also simplify for my non-geek brethren, Newton’s Laws of Motion where Force =Mass X Acceleration (F=MA) to start this topic. In short, in order to produce a large amount of force (F), there is a product of the weight of the object (mass of the dumbbell) and how quickly you can accelerate (A) that dumbbell.

This is a fantastic nugget of knowledge for all weight lifters, as we can see a large benefit to moving heavy weight as quickly and safely as possible (this is a lifestyle right), to achieve a greater force production. In fact, this rapid concentric movement has shown to require the activation of high threshold motor units (HTMU’s), which are the specific muscle fiber types that are just as adaptive to quick movements as they are to grow bigger and stronger.

The formula is sound, so let’s close the book on this and all just toss the weights around right? WRONG…

Pound for pound, our bodies were designed to handle large amounts of load and compression. In fact, while running, the lower extremities attenuate or absorb nearly two to three times our own body weight; and that’s on one leg at a time. However, we don’t live in a simple singular force world, where compression is absent of translational and rotational movements. It’s the combination of these dynamic forces that, when not checked by active muscle strength and passive joint stability, overtime lead to injuries.

RELATED: THE TRUTH BEHIND RUNNING INJURY SCIENCE

Why Deceleration Is The Key To Injury Prevention

When we solely focus on the acceleration of a movement, we omit any true benefit to our real life functional demands (I.E. survival). Hence, we need to focus equally on the deceleration of a mass, even as far at times to doubling our efforts of force deceleration in order to adapt our nervous system and musculoskeletal system to appropriately progress. Think of any sports event where plant and cut maneuvers, faking out an opponent, reversal of direction, landing, and hitting are a part of, and now you are thinking about deceleration or eccentric muscle strength and motor control.

RELATED: PREVENTING THE ACL INJURY EPIDEMIC W/ STRENGTH & CONDITIONING

If you still think that slow movements in the gym are preposterous, I would loosely agree based on the training age of the lifter, but as for the eccentric portion of the lift, I would say, “your are dead wrong”.

In fact many studies have demonstrated that when the emphasis is placed on the eccentric portion of the lift, there was a greater increase in muscle mass, force production, strength gains, and even fat loss. We can again use the concept of time under tension (TUT) to explain these adaptations, as well as the fact that our muscles can handle heavier loads during the eccentric portion of the lift, exposing the tissue to greater overload and subsequent repair and adaptation.

Simply stated, deceleration of a body in motion requires first, the ability to absorb the initial forces of acceleration, and second, to take on the upward forces of the ground, known as a ground reaction force (GRF).

So in order to see positive changes occur in optimal joint stability, muscle strength, and injury prevention, there needs to be an emphasis on the eccentric phase of the lift.

Train Slow To Regrow

Say for example we send a baby off into the void we call space (a chilling thought but humor me here). This baby would travel around for the good of 15 years and then return to earth. Upon return the child would most likely still be human, but many of the bony anatomical features we would consider normal would most likely not be found, such as fusion of certain joints, the proliferation of hard and soft bone, and the natural curvatures and spiral adaptation seen in the long bones of our legs and arms.

We are a product of our environment to the highest order. Without stimulus there can be no change. The same is true with mechanical conditioning of soft tissue to enhance growth and following an injury, this would translate to healing.

Mechanotransduction, or the process of converting a mechanical stimulus into a biochemical signal, is what occurs to all of our tissues when placed under a load. This point maybe too simple, but a single repetition is a repetition that can never be undone. Thus, we are a product of the cumulative load of our entire lives. What? Ok, ok, let’s move on.

Protecting Your Tendons To Stay Injury Free 

Because tendons are most commonly injured let’s focus here for a moment. Tendons are known to heal with scar tissue, which as we know is quite inferior at withstanding similar loads placed on it when compared to non-injured tissue. This is all due to tendons being biochemically and metabolically less active than bone or muscle. Therefore, increased TUT and overload are what we need to proliferative changes (Tendon cell growth).

With chronic tendon injuries there is usually a history of episodic pain that comes and goes; typically provoked by an increase in the frequency of repetitive loaded task that encompasses short eccentric phases.

Though the injured tendon most likely went through a normal round of inflammation, the slow response to healing and often lack of proper remediation/rehab with the “I thought it would just get better if I took some anti-inflammatories and rested it better” mentality creates a greater likelihood of repeat injury. The lack of healing becomes chronic and the tissues become hypersensitive and scarred up.

In the rehab world, we would properly treat a pathological tendon by using eccentric loading, and it’s from this form of treatment that we can also derive how to maintain tendon health for the prevention of future injuries.

Eccentric training in the research literature has shown much success with rehab to ACL’s repairs, chronic hamstring strains, bicep tendons, Achilles tendons, and less specific tendinopathy. The following outlined protocol will allow us to arrive at understanding what is used specifically to regenerate tendon tissue, and how this can also maintain and improve tendon health towards the prevention of tendon, ligament, and joint capsule injuries.

Disclaimer: Treatment for chronic pathological tendons should be sought out from a licensed practitioner as arriving at a proper diagnosis is essential for proper rehabilitation. If you are in doubt of finding the most qualified practitioner in your area, consult with Dr. John Rusin, who has developed a very large network of great therapists across the country.

Most often, the setup uses either bodyweight or added resistance via a machine or other novel approaches, using a 2/1 technique. An example of this would be, performing a leg press at the start (or concentric) phase of the lift with two limbs, and then the eccentric phase is performed with the single injured limb. The same set up for a hamstring maybe using Nordic eccentric body weight hamstring exercise or a machine based exercise such as the leg press example.

It is the eccentric force that literally flushes excessive viscous fluid out of the injured site which, combined with the mechanotransduction of the load, literally induces the synthesis or building of new type 1 collagen (as my father would say, “the good stuff”).

Warning: Eccentric loads create more muscle damage and hypertrophy. Selecting the correct % 1RM should be based on the specific and subject criteria you provide your practitioner with. Don’t be a jerk, learn from your local guru’s and execute it right.

Eccentric Training Protocol

Total episode of treatment: 12 wks

Frequency: 2x/day

Reps/sets: 3×15, advanced high level athletes 4×80

Tempo: 4110, advance high level athletes 5110

Example Movement: Barbell RDL with 7-second eccentric

How To Apply These Principles In Your Training

Knowing what rebuilds torn up tendons should allow us the prospective of understanding that applying the same principles to our everyday training can then further strengthen and fortify our tendons to be more resilient to injury. Hence, we can really make a difference in the longevity of our lifting carriers by simply slowing down where it matters most.

In a day in age where everything is moving so fast, we must learn to work hard and appreciate the passage of time.

The Application Of Eccentric Training

When we think deceleration we think slowing down, but how slow is slow?

Rather than debate this with feel and anecdote, lets apply the science behind lifting tempo to explore why certain rates of deceleration and holds should be prioritized for specific muscles groups.

Tempo

Here is how to read it, and yes bring a watch.

Eccentric-Rest-Concentric-Contraction: 3012, or 3X12

*3 seconds eccentric, 0 seconds Rest, 1 second concentric, 2 seconds holding the contraction

Example Movement: Barbell Back Squat

The Novice Lifter

New lifters are often lost to the power of the mind-muscle connection and are very eager to move weight and rack up the pounds. Therefore, it’s difficult to have them use lower weights, but with the right tempo, we can not only make the weights feel heavier, we can also increase their gains in strength, neuromuscular recruitment, and most importantly muscle hypertrophy via an increase in protein synthesis duration. Getting results and educating on the long term benefits of safety and progression, are what create success at both ends of a trainer and trainee relationship.

RELATED: DEVELOPING A MIND-MUSCLE CONNECTION FOR MUSCLE HYPERTROPHY

Example Movement: Barbell Biceps Curl

The Set Up

50-60% 1RM

Sets/Reps/Rest: 3-5/failure/60 seconds (for optimal body composition)

Upper extremities : 3013 (machine/free weight/body weight, except pull-ups)

Lower extremities (machine based): 6121

Lower extremities (free weight): 4020

Lower extremities (Eccentric Isometrics): Beginner: 4212 / Advanced: 2712

Build Muscle & Burn Fat

There are times to cut and times to bulk right? Wrong.

We now know that these forms of drastic weight gain and weight loss are not optimal for overall health and metabolism. Bulking and then cutting are a sure fire way to wreck your metabolic state and create poor eating habits. Hey “If It Fits Your Macros” is a way of life for some, but not for others.

Research has shown that using certain tempo parameters and short rest periods can increase metabolic exercise post oxygen consumption and blood lactate. This both increases a cascade of hormones and growth factors that are principles in turning on protein synthesis or muscle building and increased metabolism and fat loss.

Example Movement: Seated Machine Hamstring Curl

The Set Up

70-80% 1RM

Set/Rep/Rest: 3-5/5-8/Beginner 60 seconds, advanced 40 seconds

Upper body & Lower Body: 4010

Advanced Contrast Training

We must go backward to go forward.

In order for any amount of work to be performed while under the laws of physics, potential energy must be converted into kinetic energy. You can’t throw a ball forward without moving the arm backwards and away from your target first.

Much of what we use to generate force comes from the ability of our muscles to rapidly store and release energy in the form of movement. This is the other end of the coin.

Rapid force production and acceleration should be trained, so don’t confuse the earlier method as the only way because you can be the most resilient to injuries but completely suck at maximal muscle power output.

Combining eccentric training with short rest periods and immediately executing a power driven movement are a potent method of training for the advanced competitive lifter and athlete.

Combining Eccentric Isometrics and Power = Cluster Training / Contrast Training

Eccentric isometrics more specifically can influence a phenomenon observed as a post activation potentiation. This potentiation, in general terms, means that certain exercise methods can prime your nervous system to create and overall increase muscle activation and rate of recruitment.

Example Movement: Neutral Grip Lat Pulldown

The Set Up

Standard Contrast training:

While performing a closed kinetic chain exercise (squat, dead-lift, bench press), perform them at an increasing %1RM (80%-90%) for 5 reps, immediately followed by 5-10 reps of a respective power driven movement (squat jump, kettle bell swing, supine medicine ball toss).

Eccentric Isometrics version:

While performing a closed kinetic chain exercise (squat, dead-lift, bench press), use %1RM (70-80%) with a tempo of 2502 for 5 reps, immediately followed by 5-10 explosive power driven movements (squat jump, kettle bell swing, supine medicine ball toss).

Conclusion

Let’s combine the science and the experience from the trenches to take our clients to the next level. Thanks again to the amazing researchers and trainers out there on the front lines making changes every day. Enjoy your injury free training!

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About The Author

Dr. Mario Novo is a results driven sports orthopedic physical therapist who specializes in strength and conditioning. Known well by his clients/patients as a mentor and educator, Mario’s passion is to unify the highest levels of rehab science with successful mind and body strength coaching. With Mario’s research having focused on new advancements in muscle hypertrophy periodization and joint health, his goals are to share his knowledge and improve on the human condition through personalized cutting edge program design. Mario currently resides in middle TN where he plans on integrating his skills and knowledge in resistance exercise and rehab to empower and inspire those individuals ready to make a change in their lives through health and fitness.

For further information or consultation please email Dr. Novo at drnovodpt@gmail.com

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REFERENCES

Br J Sports Med. 2009 Aug;43(8):556-68. doi: 10.1136/bjsm.2008.051417. Epub 2008 Nov 3. Injuries

The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. Roig M¹, O’Brien K, Kirk G, Murray R, McKinnon P, Shadgan B, Reid WD.

Lorenz, Daniel, and Michael Reiman. “THE ROLE AND IMPLEMENTATION OF ECCENTRIC TRAINING IN ATHLETIC REHABILITATION: TENDINOPATHY, HAMSTRING STRAINS, AND ACL RECONSTRUCTION.” International Journal of Sports Physical Therapy 6.1 (2011): 27–44. Print.

Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy, J L Cook and C R Purdam, Br. J. Sports Med. 2009;43;409-416; originally published online 23 Sep 2008; doi:10.1136/bjsm.2008.051193

Tendon Injury and Tendinopathy: Healing and Repair, Pankaj Sharma and Nicola Maffulli; J. Bone Joint Surg. Am. 87:187-202, 2005. doi:10.2106/JBJS.D.01850

Skeletal Muscle Injuries: A Brief Review of Structure and Function

Walter R. Frontera • Julien Ochala; Calcif Tissue Int, DOI 10.1007/s00223-014-9915-y

Lorenz, Daniel, and Michael Reiman. “THE ROLE AND IMPLEMENTATION OF ECCENTRIC TRAINING IN ATHLETIC REHABILITATION INJURIES: TENDINOPATHY, HAMSTRING STRAINS, AND ACL RECONSTRUCTION.” International Journal of Sports Physical Therapy 6.1 (2011): 27–44. Print.

Maffulli and U. G. Longo “How do eccentric exercises work in tendinopathy?” Rheumatology (2008) 47 (10): 1444-1445 first published online August 12, 2008 doi:10.1093/rheumatology/ken337 Injuries

Seedman, J. (2015). The Best Way to Lift Weights. Retrieved March 24, 2015, from https://www.t-nation.com/training/best-way-to-lift-weights

Thibaudeau, Christian. “Muscles for Athletes – Part 1 The Science of High-Threshold Motor Recruitment for Hypertrophy.” Www.t-nation.com. N.p., 15 Mar. 2007. Web. 19 Nov. 2015. Injuries

Poliquin Group. “Ten Things You Should Know about Tempo Training.”Http://main.poliquingroup.com/. N.p., 21 June 2012. Web. 19 Nov. 2015.