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. 2021 Jan;53(1):124-130.
doi: 10.1249/MSS.0000000000002459.

Exercise Progression to Incrementally Load the Achilles Tendon

Josh R Baxter  1 , Patrick Corrigan  2 , Todd J Hullfish  1 , Patrick O'Rourke  3 , Karin Grävare Silbernagel  3
Affiliations

Exercise Progression to Incrementally Load the Achilles Tendon

Josh R Baxter et al. Med Sci Sports Exerc. 2021 Jan.

Abstract

Purpose: The purposes of our study were to evaluate Achilles tendon loading profiles of various exercises and to develop guidelines to incrementally increase the rate and magnitude of Achilles tendon loading during rehabilitation.

Methods: Eight healthy young adults completed a battery of rehabilitation exercises. During each exercise, we collected three-dimensional motion capture and ground reaction force data to estimate Achilles tendon loading biomechanics. Using these loading estimates, we developed an exercise progression that incrementally increases Achilles tendon loading based on the magnitude, duration, and rate of tendon loading.

Results: We found that Achilles tendon loading could be incrementally increased using a set of either isolated ankle movements or multijoint movements. Peak Achilles tendon loads varied more than 12-fold, from 0.5 bodyweights during a seated heel raise to 7.3 bodyweights during a forward single-leg hop. Asymmetric stepping movements like lunges, step ups, and step downs provide additional flexibility for prescribing tendon loading on a side-specific manner.

Conclusion: By establishing progressions for Achilles tendon loading, rehabilitative care can be tailored to address the specific needs of each patient. Our comprehensive data set also provides clinicians and researchers guidelines on how to alter magnitude, duration, and rate of loading to design new exercises and exercise progressions based on the clinical need.

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References

    1. Hillin CD, Fryhofer GW, Freedman BR, et al. Effects of immobilization angle on tendon healing after Achilles rupture in a rat model. J Orthop Res . 2019;37(3):562–73.
    1. Kangas J, Pajala A, Siira P, Hämäläinen M, Leppilahti J. Early functional treatment versus early immobilization in tension of the musculotendinous unit after Achilles rupture repair. J Trauma . 2003;54(6):1171–80.
    1. McCormack R, Bovard J. Early functional rehabilitation or cast immobilisation for the postoperative management of acute Achilles tendon rupture? A systematic review and meta-analysis of randomised controlled trials. Br J Sports Med . 2015;49(20):1329–35.
    1. Porter MD, Shadbolt B. Randomized controlled trial of accelerated rehabilitation versus standard protocol following surgical repair of ruptured Achilles tendon: Achilles tendon rehabilitation. ANZ J Surg . 2015;85(5):373–7.
    1. Grävare Silbernagel K, Crossley KM. A proposed return-to-sport program for patients with midportion Achilles tendinopathy: rationale and implementation. J Orthop Sports Phys Ther . 2015;45(11):876–86.

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