Considering the great popularity of eccentric-based training, the purpose of this review is to first provide the scientific rationale for its use; second, summarize the eccentric-based training modalities that can be used; and finally, offer practical recommendations on how to implement eccentricbased modalities to enhance sports performance. The molecular and neural mechanisms underlying eccentric actions are partially distinct from those of concentric and isometric actions. During eccentric actions, theories suggest a strain-induced modulation of actin-myosin interactions at the crossbridge level, activation of structural protein titin, and winding of titin on actin. Eccentric acute physiological responses differ from concentric exercise responses, including variations in neuromuscular, metabolic, hormonal, and anabolic signaling. Eccentric training elicits greater improvements in muscle strength, power, and stretch-shortening cycle function compared with concentric-only or traditional resistance training. Therefore, eccentric-based training can lead to unique neuromuscular (e.g., improved coordination of motor units) and morphological (e.g., increased muscle fascicle length and enhanced distal cross-sectional area) adaptations that could play a key role in sport performance. Practitioners may implement eccentric exercises with external loads, fully eccentric-based exercises (e.g., Nordic hamstring curl), accentuated eccentric loading, flywheel resistance exercise, and plyometrics to develop specific physical adaptations in line with their goals. Eccentric work (e.g., for hamstrings) can be obtained during other exercises such as downhill running tasks, decelerations, and sprinting activities. Practitioners need to be aware that no single “silver bullet” training modality exists; consequently, practitioners should use a combination of eccentric-based training approaches with their athletes to obtain the desired adaptations.

Sheri Walters’ journey to Director of Sports Medicine at Texas A&M University reflects a career defined by innovation, collaboration, and comprehensive integration. Walters discusses the "arms race" in collegiate athletics and how Texas A&M shatters silos through unit alignment and being intentionally present. Drawing from her EXOS experience, she highlights the impact of integrating sports medicine with strength and conditioning. Walters employs research-based cross-body training to maintain strength, prioritizing long-term rehabilitation over limb symmetry index testing. She explains how her Certified Strength and Conditioning Specialist® (CSCS®) and Certified Performance and Sport Scientist® (CPSS®) credentials enable her to elevate rehabilitation and speak the language of sport performance professionals. Walters underscores the importance of getting student-athletes back to team strength and conditioning as soon as tissues can tolerate it to promote physiological and psychological healing. She also shares how strength and conditioning coaches can optimize return to performance and reduce reinjury risk. Email Sheri at swalters@athletics.tamu.edu | Find Eric on Instagram: @ericmcmahoncscs and LinkedIn: @ericmcmahoncscs Catch Sheri’s session on bridging the gap in the collegiate setting LIVE at the 2025 NSCA Coaches Conference! Register to watch online at NSCA.com/Coaches. Fascinated by the intersection between strength and conditioning and sports medicine? Join other professionals in the Sports Medicine/Rehabilitation Specialist Interest Group (SIG) to discover more resources and engage in discussion.

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