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Updated: Dec 13, 2025

Author Spotlight: Exploring the Complexities of Achilles Tendon Injuries — Research and Future Directions
Published on: October 27, 2023
Different Time Course of Recovery in Achilles Tendon Thickness After Low-Load Resistance Training With and Without
Context:
Blood flow restriction research has focused on muscular strength and hypertrophy. Limited data have been reported about the blood flow restriction effect on the tendon.
Objective:
To analyze and compare the time course of recovery in Achilles tendon thickness after a single bout of low-intensity resistance training (LI-RT) and low-intensity blood flow restriction training (LI-BFRT).
Methods:
A total of 56 healthy participants (24.60 [4.0] y; 23.65 [3.4] body mass index) were included. The dominant leg was assigned for LI-BFRT using low load (30% 1-repetition maximum) and 30% of the total occlusion pressure (52.21 [17.89] mm Hg) in plantar-flexion exercise (1 × 30 + 3 × 15 repetitions). The nondominant leg was assumed as a control condition.
Main Outcome Measure:
Sonography images were taken before the intervention, immediately posttraining, and 24 hours after exercise (post-24) for the Achilles tendon thickness.
Results:
Changes in Achilles tendon thickness for LI-BFRT group were significant post- (-14.5%; P < .05) and post-24 (-9.2%; P < .05). In contrast, LI-RT group showed a transient decrease after exercise (-9.67%; P < .05) followed by a recovery of thickness post-24 (-1.06%; P < .05). Thickness post-24 was different between LI-BFRT versus LI-RT (P < .01). Hedge effect size analysis showed a large effect (g = 0.90) in LI-BFRT pre-post condition and a medium effect (g = 0.57) in post- to post-24. The LI-RT obtained a medium effect (g = 0.53) in pre-post condition and a small effect (g = 0.49) in post- to post-24.
Conclusions:
This study showed a different time course of the acute response in Achilles tendon thickness between LI-BFRT and LI-RT. This may be associated with intratendinous fluid movement in response to LI-BFRT.
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