Adherence to Eccentric Loading Programmes for Achilles Tendinopathy: What the Trial Evidence Shows
DOI:
https://doi.org/10.5281/zenodo.22548303Keywords:
Achilles tendinopathy, Eccentric exercise, Adherence, Heel-drop protocol, Heavy slow resistance, RehabilitationAbstract
Heavy-load eccentric calf-muscle training is a first-line, guideline-recommended treatment for chronic
mid-portion Achilles tendinopathy, yet the trials that established its efficacy also recorded meaningful
rates of non-completion, and pain provoked by the exercise itself is consistently the most cited reason
patients stop before the protocol is finished. This review synthesises the randomised and observational
literature on eccentric-loading protocols for Achilles tendinopathy, focusing specifically on what is
known about adherence: how protocol duration, supervision, pain-monitoring guidance, and the choice
between eccentric-only and heavy-slow-resistance loading each shape whether patients complete the
programme they were prescribed. Original Research was not attempted here, since no new cohort was
collected; instead the aim is to set out, from the published record, what is known and what remains
poorly characterised about adherence to these protocols.
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