Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy

Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy. Sayana MK, Maffulli N. J Sci Med Sport. 2007 Feb;10(1):52-8. Epub 2006 Jul 7.

OBJECTIVE: Achilles tendinopathy is prevalent in athletes, but can also affect sedentary patients. We studied the effects of eccentric exercises in sedentary non-athletic patients with Achilles tendinopathy.
METHODS: Thirty-four sedentary patients (18 males, average age 44 years, range 23-67; 16 females, average age 51 years, range 20-76; average BMI: 28.6+/-4.7, range 22.1-35.4) with a clinical diagnosis of unilateral tendinopathy of the main body of the Achilles tendon completed the VISA-A questionnaire at first attendance (39+/-S.D. 22.8) and at their subsequent visits. The patients underwent a graded progressive eccentric calf strengthening exercises programme for 12 weeks.
RESULTS: Fifteen patients (44%) did not improve with eccentric exercise regimen. Three patients improved after perintendinous injections aprotinin and local anaesthetic. Surgery was performed in seven patients as 6 months of conservative management failed to produce improvements. The overall average VISA-A scores at latest follow up was 50 (S.D. 26.5).
CONCLUSIONS: Eccentric exercises, though effective in nearly 60% of our patients, may not benefit sedentary patients to the same extent reported in athletes.

Diagnosis: Mid portion Achilles tendinitis (2-6 cm above insertion)

Outcome: VISA-A 56% improved VISA-A score at least 10 points and did not have pain that interfered with activity, 44% didn’t respond

When Assessed: 12 weeks

Subjects: 34 sedentary adults, ave age 44

Protocol: 1x 10 to 3 sets of 15, 2x per day, 7 days per week, for 12 weeks, rep speed varied from slow to fast

Other Activity: Sedentary

Chad’s Comments: Bodyweight calf raises might be of higher relative intensity for sedentary people as compared with athletes and might explain why the results are not as good.  As such it is probably prudent for less active sufferers of Achilles tendinitis to do their calf training on an exercise machine where they can start with lighter than bodyweight exercise and progress upwards from there.  Anecdotally I have had great results doing this in my physical therapy office.

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Chad Reilly is a Physical Therapist, obtaining his Master’s in Physical Therapy from Northern Arizona University. He graduated Summa Cum Laude with a B.S. Exercise Science also from NAU. He is a Certified Strength and Conditioning Specialist, and holds a USA Weightlifting Club Coach Certification as well as a NASM Personal Training Certificate. Chad completed his Yoga Teacher Training at Sampoorna Yoga in Goa, India.

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