Achilles tendinopathy

Expert Discussion Recovery and Regeneration
1

Hi there!

Could anyone with access to the full text paper please be so kind and post (or PM me) the eccentric stretching protocol used in this paper:

Chronic Achilles Tendinopathy Treated With Eccentric Stretching Program. Foot Ankle Int, September 2011, 32: 843-849.

The abstract doesn’t have sufficient information about what exactly they did.

Thanks so much for your kind help,
Robin.

2

Hi

When it comes to Eccentric stretching of Achilles there is really limited number of exercises, some of the researches using Alfredson’s heel-drop exercise program http://img2.timg.co.il/forums/1_115845356.pdf

The article you are asking for is difficult to get, I have found similar onehttp://prdupl02.ynet.co.il/ForumFiles_2/23378056.pdf
or
http://njsportsmed.com/files/alfredson-heavy_load_eccentric_achilles.pdf

The exercises for Achilles tendinopathy are similar the protocols are different (reps, sets, an extra weight, etc…)

Anyway one of athlete I coach used those exercises for 5-6 weeks, it works.

3

This protocols doesn’t work for sprinters. In the results section the data show no change in torque at the ankle joint of the injured leg. Eccentrics help with pain relief because of the deep stretch.

4

Yes, the reason why I’m interested in this paper is because I feel that it is the Achilles stretching (rather than calf strengthening) which occurs during eccentric calf training that is probably responsible for the effect of the Alfredson protocol. This would mean that the same effect could be achieved with a stretching routine which is much easier to carry out. This paper seems to confirm this, but I can’t see what exactly they did since I don’t have access to the full paper.

Do you have any thoughts on a protocol that works well for sprinters, Sharmer?

5

Not sure if this will help, but a former training partner of mine is a co-author of this paper

http://www.jfootankleres.com/content/5/1/15

6

well my experience is different with those protocols, also Rudi Diels is a personal coach to Belgian sprinter Kim Gevaert is also using similar protocols while she was recovering from Achilles problems, (most of the “specialists” recommended surgery, with that protocol she was able to recover in 6/7 weeks).

7

I can email you the paper.

I’ve found skipping and single leg hopping to be effective. But there must be some type of soft tissue massage done on the gastroc and soleus. The prerequisite to single leg hopping would be to able to skip 2-3 minutes without pain.

8

Thanks. I have PMed you my email address. By skipping, do you mean rope skipping? Can you describe the protocol you use(d) in a bit more detail please?

Thanks,
Robin.

9

I emailed the paper.

Yes with a rope.

I found that if you can skip continuously up to 5 minutes without pain then there should be no problems with sprinting.

Good starting point would be 5 sets of 30seconds x 2 weekly.

If there’s pain during skipping then the Achilles is not ready for sprinting.

I’ve read most of the literature on AT injuries. Tried different protocols. Discussed the injury with various sports doctors and discussed designing a protocol with university professors. The problem being sprinters are a very small group with unique physiological traits and there are no studies on sprinters. It’s very difficult actually get enough subjects to even go ahead with a study.

Most of the studies are based out of hospitals. Such as the Alfredson protocols. It’s easy to get subjects but these studies are very limited. They have very little application to sports specific events because they use average sedentary males.

Whilst some individuals reports benefits with the eccentrics. Benefits maybe placebo or it maybe simply other co-variables which maybe account for improvements in symptoms.

10

So you start off with bilateral skipping and then progress to unilateral when you can do a few minutes without pain? Do you see skipping as a diagnostic tool to assess readiness for sprinting or do you find that it actually improves the condition?

11

If you can do bilateral skipping for 30 seconds without pain then you can progress to unilateral skipping.

I find it improves the function of the tendon; probably through increased neuromuscular control. But you can use it as a diagnostic tool too.

12

https://uc-d.adobeconnect.com/_a841422360/exb179/?launcher=false&disclaimer-consent=true

Talking about this now on live feed. Kim, Stuart PhD

Full Line up at UC Davis link below.

https://twitter.com/MuscleScience/status/445315961684369408/photo/1

https://twitter.com/MuscleScience/status/445315961684369408/photo/1