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Background and Purpose: The capacity of the Achilles tendon during a 1-repetition eccentric maximum contraction is largely unknown. This study examined the maximum ankle torque during a concentric/ eccentric heel raise/lowering task and while running in healthy individuals and participants with chronic Achilles tendinopathy. These findings were applied to a 10-week training program for a patient with chronic Achilles tendinopathy.

Methods: A total of 13 subjects (9 healthy and 4 with Achilles tendinopathy) participated in this study. Subjects were asked to perform a maximum eccentric contraction wearing a weighted vest while collecting 3-dimensional biomechanical variables. Subjects also ran along an instrumented runway to assess torque at the ankle joint. All participants completed VISA-A

Outcomes: On the VISA-A, subjects with Achilles tendinopathy (AT) scored on average 28 points less than the healthy controls and were 27% weaker. The peak ankle torque during a single leg lowering task and running was 3.1 Nm/kg and appeared similar between controls and participants with chronic AT. Findings of the study when applied in a 10-week high load eccentric rehabilitation program demonstrated improved tendon characteristics and VISA-A score.

Conclusion: Unhealthy tendons likely can tolerate high loads during rehabilitation and AT programs should consist of progressive resistive exercises instead of movements that emphasize repetitions.


Originally published in Orthopaedic Physical Therapy Practice (ORTHOP PHYS THER PRACT), 2018; 30(4): 543-547. (5p)