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The American Journal of Sports Medicine 26:360-366 (1998)
© 1998 American Orthopaedic Society for Sports Medicine

Heavy-Load Eccentric Calf Muscle Training For the Treatment of Chronic Achilles Tendinosis

Håkan Alfredson, MD, Tom Pietilä, RPT, Per Jonsson, RPT and Ronny Lorentzon, MD, PhD*

Sports Medicine Unit, Department of Orthopaedic Surgery, University Hospital of Northern Sweden, Umeå, Sweden

* Address correspondence and reprint requests to Ronny Lorentzon, MD, PhD, Sports Medicine Unit, University of Umeå, S-901 87 Umeå, Sweden

We prospectively studied the effect of heavy-load eccentric calf muscle training in 15 recreational athletes (12 men and 3 women; mean age, 44.3 ± 7.0 years) who had the diagnosis of chronic Achilles tendinosis (degenerative changes) with a long duration of symptoms despite conventional nonsurgical treatment. Calf muscle strength and the amount of pain during activity (recorded on a visual analog scale) were measured before onset of training and after 12 weeks of eccentric training. At week 0, all patients had Achilles tendon pain not allowing running activity, and there was significantly lower eccentric and concentric calf muscle strength on the injured compared with the noninjured side. After the 12-week training period, all 15 patients were back at their preinjury levels with full running activity. There was a significant decrease in pain during activity, and the calf muscle strength on the injured side had increased significantly and did not differ significantly from that of the noninjured side. A comparison group of 15 recreational athletes with the same diagnosis and a long duration of symptoms had been treated conventionally, i.e., rest, nonsteroidal antiinflammatory drugs, changes of shoes or orthoses, physical therapy, and in all cases also with ordinary training programs. In no case was the conventional treatment successful, and all patients were ultimately treated surgically. Our treatment model with heavy-load eccentric calf muscle training has a very good short-term effect on athletes in their early forties.




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