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Author Spotlight: Effectiveness of Extracorporeal Shockwave Therapy in Achilles Tendinopathy Treatment
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WHY ARE ECCENTRIC EXERCISES EFFECTIVE FOR ACHILLES TENDINOPATHY?

Seth O'Neill1, Paul J Watson1, Simon Barry2

  • 1University of Leicester, Leicester, UK.

International Journal of Sports Physical Therapy
|September 9, 2015
PubMed
Summary

Eccentric exercises are a common treatment for Achilles tendinopathy. This review suggests that muscle adaptations, not tendon changes, may be the primary mechanism for clinical improvement in Achilles tendinopathy.

Keywords:
AchillesTend*eccentric exerciseefficacy

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Rehabilitation Science

Background:

  • Achilles tendinopathy is a prevalent condition often treated with eccentric exercises.
  • The precise mechanisms underlying the effectiveness of eccentric exercises remain unclear.
  • Current theories focus on tendon adaptation, which may not align with clinical recovery timelines.

Purpose of the Study:

  • To critically review proposed mechanisms of eccentric exercise for Achilles tendinopathy.
  • To explore alternative pathways, specifically focusing on muscle alterations.
  • To propose a novel mechanism involving plantarflexor muscle function in Achilles tendon health.

Main Methods:

  • Literature review and critical analysis of existing theories.
  • Examination of evidence regarding muscle alterations in Achilles tendinopathy.
  • Synthesis of findings to propose a new therapeutic mechanism.

Main Results:

  • Tendon adaptation may not fully explain clinical improvements in Achilles tendinopathy.
  • Muscle alterations are observed before and during Achilles tendinopathy.
  • These muscle changes are responsive to treatment and can reduce tendon load.

Conclusions:

  • Eccentric exercise benefits for Achilles tendinopathy may stem from muscle adaptations rather than direct tendon remodeling.
  • Plantarflexor muscle alterations could play a protective role, shielding the Achilles tendon.
  • Further research into muscle-tendon interactions is crucial for optimizing rehabilitation strategies.