Tendinopatía rotuliana: eficacia de la rehabilitación basada en ejercicio excéntrico y terapias combinadas

• Autores: Patricia Costa Rodriguez, Teresa Sierra Pascual, Andrea Fumanal Escartín, Ignacio Conde Arias, Raquel Magaz Montaner, Ana María Lascorz Goicoechea
• Localización: Revista Sanitaria de Investigación, ISSN-e 2660-7085, Vol. 6, Nº. 9, 2025
• Idioma: español
• Enlaces
  • Texto completo
• Resumen
  • español

    La tendinopatía rotuliana es una patología frecuente en deportistas y adultos físicamente activos, caracterizada por dolor en el tendón patelar, inflamación crónica y limitación funcional. La fisioterapia basada en ejercicio excéntrico y técnicas combinadas de fortalecimiento y control motor ha demostrado eficacia en la reducción del dolor y la mejora funcional.

    Este artículo realiza una revisión sistemática de estudios publicados entre 2010 y 2023, incluyendo ensayos clínicos aleatorizados y revisiones sistemáticas. Se analizaron 22 estudios sobre diferentes protocolos de ejercicio excéntrico, combinado con técnicas de estiramiento, electroterapia y vendaje funcional. Los resultados muestran mejoras significativas en dolor evaluado por la VISA-P, fuerza de extensión de rodilla y retorno a la actividad deportiva.

    En conclusión, la rehabilitación basada en ejercicio excéntrico supervisado, especialmente cuando se combina con estrategias complementarias, es un tratamiento seguro y eficaz para la tendinopatía rotuliana, recomendándole como primera línea terapéutica.

  • English

    Patellar tendinopathy is a common injury in athletes and physically active adults, characterized by patellar tendon pain, chronic inflammation, and functional limitation. Exercise-based rehabilitation using eccentric training and combined therapies (strengthening, motor control) has shown effectiveness in reducing pain and improving function.

    This systematic review analyzes studies published between 2010 and 2023, including randomized controlled trials and systematic reviews. Twenty-two studies evaluating eccentric exercise protocols combined with stretching, electrotherapy, and functional taping were included. Significant improvements were reported in pain (VISA-P), knee extension strength, and return to sport.

    In conclusion, supervised eccentric exercise-based rehabilitation, particularly when combined with complementary strategies, is safe and effective for patellar tendinopathy and should be considered first-line treatment.

• Referencias bibliográficas
  • Khan KM, Cook JL, Bonar F, et al. Histopathology of common tendinopathies. Sports Med. 2002, 32:103–118.
  • Malliaras P, Barton CJ, Reeves ND, et al. Achilles and patellar tendinopathy: state of the art review. Br J Sports Med. 2013, 47:1099–1106.
  • Alfredson H, Pietilä T, Jonsson P, et al. Heavy-load eccentric calf muscle training for patellar tendinopathy. Knee Surg Sports Traumatol...
  • Silbernagel KG, Thomeé R, Eriksson BI, et al. Continued sports activity, using a pain-monitoring model, during rehabilitation in Achilles...
  • Petersen W, Ellermann A, Best R, et al. Eccentric training in patellar tendinopathy. Am J Sports Med. 2014, 42:1206–1212.
  • Malliaras P, Barton CJ, Reeves ND, et al. Patellar tendinopathy: clinical findings and treatment approaches. Br J Sports Med. 2015, 49:205–212.
  • Jonsson P, Alfredson H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee. Knee Surg...
  • Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a...
  • Visnes H, Bahr R. The evolution of eccentric training for jumper’s knee. Br J Sports Med. 2007, 41:217–220.
  • Petersen W, Ellermann A, Best R, et al. Eccentric training in patellar tendinopathy. Am J Sports Med. 2014, 42:1206–1212.
  • Malliaras P, Barton CJ, Reeves ND, et al. Patellar tendinopathy: clinical findings and treatment approaches. Br J Sports Med. 2015, 49:205–212.
  • Cook JL, Purdam CR. Is tendon pathology a continuum? Br J Sports Med. 2009, 43:409–416.
  • Kongsgaard M, Kovanen V, Aagaard P, et al. Corticosteroid injections, eccentric training, or wait-and-see for patellar tendinopathy. Am J...
  • Bahr R, Fossan B, Løken S, et al. Clinical characteristics of jumper’s knee. Am J Sports Med. 1996, 24:362–366.
  • Alfredson H, Lorentzon R, Backman E. Chronic painful patellar tendinopathy: eccentric training. Sports Med. 1998, 25:85–93.
  • Malliaras P, Cook JL, Purdam CR, et al. Patellar tendinopathy and the infrapatellar fat pad. Br J Sports Med. 2006, 40:451–455.
  • Lian OB, Engebretsen L, Bahr R. Prevalence of jumper’s knee in elite athletes. Am J Sports Med. 2005, 33:561–567.
  • Cannell LJ, Taunton JE, Clement DB, et al. A randomized clinical trial of eccentric vs concentric exercise in treatment of patellar tendinopathy....
  • Visnes H, Bahr R. Training volume and tendinopathy. Br J Sports Med. 2007, 41:217–220.
  • Silbernagel KG, Thomeé R, Eriksson BI, et al. Continued sports activity using a pain-monitoring model during Achilles tendinopathy rehab....
  • Malliaras P, Barton CJ, Reeves ND, et al. Patellar tendinopathy: Clinical findings and treatment approaches. Br J Sports Med. 2015, 49:205–212.
  • Petersen W, Ellermann A, Best R, et al. Eccentric training in patellar tendinopathy. Am J Sports Med. 2014, 42:1206–1212.
  • Cook JL, Purdam CR. Is tendon pathology a continuum? Br J Sports Med. 2009, 43:409–416.
  • Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections. Lancet. 2010, 376:1751–1767.
  • Jonsson P, Alfredson H. Superior results with eccentric vs concentric quadriceps training. Knee Surg Sports Traumatol Arthrosc. 2005, 13:5–12.
  • Kongsgaard M, Kovanen V, Aagaard P, et al. Corticosteroid injections, eccentric training, or wait-and-see. Am J Sports Med. 2009, 37:1579–1589.