Tendinopathies part three - Exercise programs

Tendinopathies part three - Exercise programs

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It is a very exciting time in the world of tendons as there is emerging research which is changing the way I manage my patients with tendinopathies.

Up until recently, to manage tendinopathies, many physiotherapists followed the Alfredson’s Tendon Protocol. This consisted of eccentric loading exercises. Eccentric loading exercises are exercises that load the tendon whilst it is lengthening. Here is a video of an eccentric exercise for the Achilles tendon.

Recent research has suggested we should no longer be managing tendon injuries in this fashion.

Instead of doing eccentric exercises, tendon rehabilitation should first start with isometric exercises for pain relief. These exercises involve contraction of a particular muscle and tendon complex without movement and holding the position statically for a length of time. An example of an isometric exercise for the Achilles tendon would be holding a calf raise as the heel gets to the top of the movement.

There has also been some media coverage on this emerging research.

Watch this video of Dr Ebonie Rio, a leading researcher in this field, discussing these new tendon exercises.

Such emerging research around tendinopathy management is fantastic for physiotherapists as it will improve what is currently a challenging injury to manage.

In our clinic, our physiotherapists have been fortunate enough to have some success with this type of management. Tendon management is progressing quickly and it is an exciting time for both patient and therapist.   

If you have had any success with this new program or any other for that matter, I would love to hear your story.

You can check out the rest of the articles on tendinopathies here:

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