Eccentrics Are Overprescribed for Climbers
Eccentric contractions are often hyped up.
The original tendon research (achilles and patellar tendons) on eccentric loading protocols has been researched for other tendons. This research shows that eccentrics aren't any "better" than different types of mechanical load (isometrics, isotonics, BFR etc.).
and it can sometimes be a problem.
Current research shows that the compressive load with eccentric protocols can be problematic for the tendon itself. It adds additional shear/compressive stress to the tendon's natural fiber direction. In multiple tendons (achilles, patellar, lateral elbow), it has been considered to propagate tendon pathology.
This is one of my concerns with loading the wrist eccentrically.
See it below:
In this image, I am showing the typical method used. Put your forearm on a bench, lower it slowly towards the ground, and curl it back up. The images at the bottom are ultrasound images of what happens at the carpal tunnel during the bottom portion of the movement with load.
The image on the left is with the wrist in a neutral position. In this example, the tendons load down their natural axis.
In the example on the right, the space becomes more narrow, approximating the tendons towards each other. In addition, the carpal bones (not visualized) would also endure shear stress between them.
We can make loading the wrist way more simple.
Keeping the wrist neutral will do the same thing (mechanically), and it feels way less risky (good for pain reduction), especially if you're an athlete with clicking in the wrist.
Here are some examples:
Wrist flexion isometric (shown on the left). Go heavy and hold for a longer time under tension.
Wrist extension isometric (opposite side of the forearm). Same idea.
Hammer curl isometric. Curl a heavy dumbbell to 90-degrees at the elbow (thumb up) and hold for time.
Tricep extension isometric. Opposite direction. Lower a heavy band or cable machine to 90-degrees (thumb up) and hold for time.
Key takeaways:
Eccentric flexion over a bench is not a very practical exercise.
With pain at the wrist, keeping it neutral is a safe and reliable method.
This controlled load needs to change as your rehab progresses.