Affiliations: [a] University of California, San Francisco/San Francisco
State University, Doctoral Program in Physical Therapy, CA, USA | [b] Department of Physical Therapy and Rehabilitation
Science, School of Medicine, University of California, San Francisco, CA,
USA
Note: [] Address for correspondence: Nancy Byl, PhD, PT, FAPTA, 1318 7th
Ave, Box 0736, San Francisco, CA 94143, USA. Tel.: +1 415 476 6650; Fax: +1
415 502 0323; E-mail: BylN@PtRehab.ucsf.edu
Abstract: Achilles tendinopathy is a common overuse injury in athletes,
especially older athletes. This condition is difficult to treat and often
becomes chronic. This evidence based review summarized the current
pathophysiological principles guiding research as well as clinical practice and
synthesized the search results to determine if eccentric exercises were
effective in the treatment of patients with Achilles tendinopathy. Seven
studies were identified, but only two were randomized clinical trials (level A
evidence) with the rest controlled clinical studies or prospective cohort
studies (level B evidence). Only one study reported follow-up one year beyond
the intervention period. Based on a crossectinal analysis of post treatment
outcomes, there was modest but significant clinical benefits following
eccentric exercise training, but insufficient evidence to predict the long-term
effects of eccentric exercise training for the management of Achilles
tendinopathy. Although randomized clinical trials with a large subject
population are still needed, eccentric exercise paired with biomedical training
techniques should be integrated into treatment guidelines for patients with
Achilles tendonitis.
