Achilles Tendon Loading Progressions

This blog is a shortened version of a review from the 18th issue of the Physio Network Research Reviews. It highlights a study titled “Achilles Tendon Loading During Weight Bearing Exercises”, reviewed by Stephen King.

Background/Objective:

• Achilles tendon injuries are common, particularly in male runners 30-50 years old
• Conservative management involving exercise and mechanical loading of the tendon is commonly recommended. However, excessive loading can lead to tendon injury
• The purpose of this study was to examine the relative stress on the achilles tendon during several commonly used exercises and to categorize them appropriately, helping clinicians to more intelligently prescribe these exercises during the rehab process

Methods:

• Each participant in the study had their achilles tendon cross-sectional area imaged via ultrasound in a neutral position
• 46 markers were placed on the participants for visual analysis and 4 force plates were used to record the impact of each exercise performed
• Differences in peak achilles tendon stress, stress rate, force, and impulse as well as ankle range of motion were measured

Results:

• See graphic, which shows the order of exercises with the lowest loads to the highest loads of the achilles tendon (row 1 to row 2)

Clinical Implications:

• The relative load ranking of the exercises used in this study provide the clinician with some simple exercise strategies for progression or regression when rehabilitating an achilles tendon injury
• They may provide a valuable guideline for exercise prescription outside of standard progressive resistance exercises isolated to the calf/ankle