TrainerForge Sign in

Conditions / Musculoskeletal

Achilles tendinopathy

Midportion Achilles tendon pain and stiffness, usually worst in the morning and at the start of activity. Loading is the treatment; rest alone is not.

Prescribe

Eccentric calf loading as the primary intervention
Train through acceptable pain, progressing by symptom response
Include both straight-knee and bent-knee calf work
Plan the block for 12 weeks and expect morning stiffness to improve first

Avoid, and why

Rest alone, which does not resolve tendinopathy
Plyometrics, running and jumping while the tendon is reactive
Jumping load levels on a day the client feels good - progression is by response, not by mood
Treating pain during loading as damage, provided it settles within 24 hours

How the generator handles this

Max exercise complexity	2
Patterns excluded	None
Balance work added	No
Clearance required first	No

Sources

Martin et al., JOSPT (2018). Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018. Source
Clinicians should use eccentric loading of the calf as the Grade A intervention for midportion Achilles tendinopathy, progressed by symptom response rather than by a fixed calendar.