Exercise and a guided hopping intervention for recreational runners with Achilles tendinopathy

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Goom, T. 2019. Achilles tendinopathy is common in runners. This study looks at adding a structured hopping regime to progressive loading in male runners with mid-portion Achilles tendinopathy. The Physio Network, 24.

This study looks at adding a structured hopping regime to progressive loading in male runners with mid-portion Achilles tendinopathy.

Patient reported tests used:

- Victorian Institute of Sport Assessment-Achille  s (VISA-A)

- Tampa scale of kinesiophobia (TSK)

- Achilles Tendon Beliefs Questionnaire

Figure 1: Ankle Pain - Achilles Tendonitis - Physio Frenchs Forest, Physio Macquarie Park

- Pain Anxiety Symptoms Scale (PASS-20)

- Maximal pain during 10 submaximal hops and hopping to fatigue (0-10)

Physical tests included:

- Standing heel raise to fatigue

- 6 rep maximum – seated heel raise and leg curl

- MMT for hip abduction and extension

- Ankle DF AROM (knee flexed and extended)

- Hopping: Leg stiffness, duration, and contact

A 12-week exercise programme was used with 4 levels which were progressively more challenging  

Results:

- Overall 13 runners completed the study.

- Adherence was 70% to the exercise program.

- By 12 weeks 77% of the participants progressed to level 4

- All Physical and subjective measures improved and were noticeable at 4 weeks.

- There was strong relationship between calf strength and hopping pain.

 Take home message:

- Rehabilitation requires use of a variety of training measures such as slow heavy resistance and plyometrics.

- Factors along the kinetic chain such as hip strength need be addressed.

- Slow increase in load over 3-4 months is necessary to achieve change in the tendon.  

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