What is Eccentric Strengthening?

Eccentric strengthening is a way of loading a muscle while it lengthens. A simple example is slowly lowering a weight after lifting it. Physiotherapists use eccentric strengthening exercises to improve tendon health, muscle strength and control during everyday and sporting tasks.

When you lower your body into a squat, step down a stair or land from a jump, your muscles work eccentrically. Training this phase in a planned way can improve how your joints cope with load and reduce the risk of future injury.

How Eccentric Strengthening Works

Muscles can contract in three main ways:

• Concentric – the muscle shortens as it produces force, such as lifting a weight.
• Eccentric – the muscle lengthens as it resists a load, such as lowering a weight in a controlled way.
• Isometric – the muscle holds at the same length, such as a wall sit.

Eccentric strengthening places high yet controlled tension through the muscle–tendon unit. This can stimulate positive changes in tendon structure, muscle fibre length and strength. Your physiotherapist can blend eccentric, concentric and isometric work into a single, balanced strengthening program.

Benefits of Eccentric Strengthening

Eccentric strengthening has several proven benefits:

1. Tendon health and pain reduction
   Progressive eccentric loading helps tendons adapt to load. It is a key part of many modern tendinopathy treatment programs, including Achilles tendinopathy and patellar tendinopathy (jumper’s knee).
2. Strength and muscle size
   Eccentric training can produce high forces with relatively low effort. Studies show it can match or exceed traditional strengthening for improving strength and muscle size when planned well.
3. Joint control and balance
   Eccentric exercises improve control when you lower, land or change direction. This can help with stairs, squats, hills and sports that involve cutting or jumping.
4. Performance in sport and activity
   Better eccentric control can improve acceleration, deceleration and change of direction. It can help runners, field and court players, jumpers and people returning to gym training after injury.
5. Function in everyday life
   Eccentric strength supports daily tasks such as standing from a chair, lowering to sit, stepping off a curb and controlling loads at work or home.

Conditions That Commonly Use Eccentric Strengthening

Physiotherapists often prescribe eccentric strengthening for:

• Tendinopathies of the Achilles, patellar, hamstring, gluteal and elbow tendons.
• Calf strains and tears, especially when returning to running and jumping.
• Hamstring strains, where eccentric work can reduce re-injury risk.
• Recurrent muscle strains and overload injuries in running and jumping sports.
• Some shoulder and elbow problems that involve tendon irritation or weakness.

Your physiotherapist will decide where eccentric strengthening fits into your overall recovery plan.

Examples of Eccentric Strengthening Exercises

These examples show how eccentric strengthening might look in practice. They are not a substitute for an assessment or personalised program.

• Eccentric calf lowers
  Stand on a step, rise up on both feet, then slowly lower down on one leg over three to five seconds. This is a classic Achilles and calf tendon exercise.
• Eccentric squat
  Lower into a squat over three to five seconds, then return to standing at a normal pace. Your physiotherapist can vary depth, tempo and weight to match your goals.
• Eccentric hamstring slider
  In a bridge position with your heels on a towel or slider, slowly slide your heels away from your body while you control the lowering. This targets the hamstrings.
• Eccentric biceps curl
  Lift the weight with both arms if needed, then slowly lower it with one arm. This loads the muscle during the lengthening phase.

A physiotherapist will adjust sets, reps, tempo and weekly frequency based on your injury, training history and goals.

How Physiotherapists Use Eccentric Strengthening

A PhysioWorks physiotherapist will usually:

• Assess your injury, strength, movement and goals.
• Identify which muscles and tendons need eccentric strengthening.
• Prescribe an individualised loading plan with clear technique and tempo.
• Progress exercises over time, based on symptoms and performance.
• Blend eccentric exercises into a broader physiotherapist-designed exercise program.

Eccentric strengthening often sits alongside education, joint mobility work, traditional strengthening, balance training and sport or work-specific drills. It is also a common part of sports injury physiotherapy and later stages of muscle strain treatment.

Is Eccentric Strengthening Safe?

Some short-term soreness during or after eccentric strengthening is common, especially early in a program. However, sharp pain, worsening night pain or swelling that builds over several days are warning signs.

A physiotherapist will guide you on:

• How much pain is acceptable during rehab.
• How to pace load increases across the week.
• When to adjust volume, weight or speed.
• How to fit rest days around your sport or work demands.

If you have medical conditions such as heart disease, diabetes or osteoporosis, or if you are unsure about starting a new exercise program, please discuss this with your health professional before pushing heavy loads.

What to Expect at PhysioWorks

At PhysioWorks, your physiotherapist will:

• Listen to your story and assess the injured area plus related joints.
• Explain why eccentric strengthening may help your specific problem.
• Design a clear, written program you can follow at home or in the gym.
• Show you how to perform each exercise safely and confidently.
• Review and progress your plan as your strength and function improve.

You will know how often to perform your eccentric exercises, how hard to work, and how long your program is likely to run. This helps you stay consistent and track your progress over time. For more detail on how physios use exercises in rehab, see our FAQ on physiotherapy exercise prescription.

What to Do Next

If you think eccentric strengthening could help your tendon or muscle problem, the safest option is a tailored program. A PhysioWorks physiotherapist can test your strength, discuss your goals and design an eccentric strengthening plan that fits your sport, work and lifestyle.

Book an appointment at one of our Brisbane clinics to start a structured program rather than guessing your way through online exercises.

Common Questions About Eccentric Strengthening

What is eccentric strengthening in physiotherapy?
Eccentric strengthening is planned loading of a muscle while it lengthens. Physiotherapists use it to build tendon load tolerance, strength and control during movements such as squatting, stepping and landing.

Which injuries benefit from eccentric strengthening exercises?
Eccentric exercises are widely used for Achilles and patellar tendinopathy, hamstring and calf problems, and many overuse tendon conditions. Your physio will advise whether this style of exercise is suitable for your situation.

How often should I do eccentric strengthening?
Many rehab programs use eccentric exercises on three to seven days per week, depending on the tendon or muscle, the stage of healing and your overall training load. Your physiotherapist will set the right frequency for you.

Related Articles

• Tendinopathy: Learn about common tendon problems, key symptoms and how loading programs such as eccentric strengthening can help.
• DOMS – Delayed-Onset Muscle Soreness: Find out why muscles can feel sore after exercise, especially when your program includes new or heavier eccentric work.
• Calf Strain & Calf Tear: Calf injuries are common in running and jumping sports. This page explains symptoms, physiotherapy care and return-to-sport planning.
• Hamstring Strain: Discover how targeted strengthening, including eccentric exercises, can cut the risk of repeat hamstring injuries.
• Cramps in Athletes: Learn how fatigue, hydration and conditioning all contribute to cramping, and how a good exercise plan can help.

Further Reading

If you would like a deeper scientific summary, this open-access review discusses eccentric exercise adaptations and health effects in more detail.

References

1. Harris-Love MO, et al. Eccentric exercise: Adaptations and applications for health and performance. Sports Med Open. 2021;7(1):74. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8628948/
2. Bright TE, et al. Effects of eccentric resistance training on measures of physical performance: A systematic review. Sports Med Open. 2023;9(1):36. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185653/
3. Prudêncio DA, et al. Eccentric exercise for mid-portion Achilles tendinopathy: Systematic review and meta-analysis. SICOT-J. 2023;9:14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9878810/
4. Bai Z, et al. Neuromuscular adaptations to eccentric training with different durations, intensities and frequencies: Systematic review and meta-analysis. Sports Med Open. 2025;11(1):14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943567/
5. Challoumas D, et al. Effectiveness of exercise treatments with or without adjuncts for mid-portion Achilles tendinopathy: A systematic review and meta-analysis. Sports Med Open. 2023;9(1):6. Available from: https://sportsmedicine-open.springeropen.com/articles/10.1186/s40798-023-00616-1

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