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Alfredson protocol for treatment of Achilles tendinosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Eccentric exercises in Achilles Tendinopathy:

The Alfredson protocol is a program of eccentric heel-drop exercises for treating Achilles tendinopathies - the eccentric movement is the heel drop and so this is the movement when the exercise is benefitting the Achilles tendinopathy (and so performed slowly - see below)

  • the protocol recommends completion of 180 eccentric repetitions a day (1)
    • currently, there is no strong rationale for this repetition volume
    • the Alfredson protocol requires patients to continue with the exercise even if pain is experienced
      • however, the patient is advised to stop if the pain becomes disabling
    • raises significant practical issues related to exercise adherence and treatment satisfaction, which may impact the overall treatment efficacy of the protocol
  • a small study showed that performing a 6-week do-as-tolerated program of eccentric heel-drop exercises, compared to the recommended 180 repetitions per day, did not lead to lesser improvement for individuals with midportion Achilles tendinopathy(1)

A pragmatic description of Eccentric Exercises for Achilles tendinopathy is provided below (2,3):

 

 

 

 

Reference:


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