Continued Sports Activity, Using a Pain-Monitoring Model, during Rehabilitation in Patients with Achilles Tendinopathy

Abstract

No negative effects could be demonstrated from continuing Achilles tendon-loading activity, such as running and jumping, with the use of a pain-monitoring model, during treatment. Our treatment protocol for patients with Achilles tendinopathy, which gradually increases the load on the Achilles tendon and calf muscle, demonstrated significant improvements. A training regimen of continued, pain-monitored, tendon-loading physical activity might therefore represent a valuable option for patients with Achilles tendinopathy.

Effectiveness of the Alfredson Protocol Compared With a Lower Repetition-Volume Protocol for Midportion Achilles Tendinopathy: A Randomized Controlled Trial

“…Power and alpha level were set a priori at 80% and 5%, respectively. A VISA-A change score of 15 points was chosen based on clinical judgment, which is wider than the clinically significant difference of 10 points used in the study by Silbernagel et al 30 …”

“…30 The rationale for these performance-related outcomes is the assessment of the tissue-remodeling aspect of eccentric exercises through mechanically loading the musculotendinous structure. 30 Future studies should consider adding these types of outcome measures.…”

Ultrasound-Guided EPI® Technique and Eccentric Exercise, New Treatment for Achilles and Patellar Tendinopathy Focused on the Region-Specific of the Tendon

“…Eccentric work on an inclined plane did not improve functional outcomes when it was done during a competitive season in volleyball [58]. In another study, continuous sporting activity did not compromise clinical outcomes at 12 months, as long as the sport was introduced incrementally ensuring minimal pain during and after loading [59]. Eccentric decline squat training and heavy slow resistance training showed good long-term clinical results, and heavy slow resistance training also resulted in advantages in pathological improvement and increased collagen turnove [60].…”

The Rehabilitation of a Runner With Iliopsoas Tendinopathy Using an Eccentric-Biased Exercise-a Case Report

“…She was informed that this should reproduce her tendon pain to no more than 5/10 (moderate pain) on the VAS. 10,14,26,53,54 This protocol is based upon research by Alfredson et al 16 who showed improvements in pain and function with this dosage and it is a frequently used dosage in the literature.…”

“…No pain was experienced during these activities. 54 used a pain monitoring model to assist with return to sport activities. As recommended, the subject in this case study began to re-introduce running when her ADL's produced no more than 2/10 pain.…”