The load borne by the Achilles tendon during exercise: a systematic review of normative values

Review written by Dr Teddy Willsey info

Key Points

  1. The Achilles tendon (AT) is the largest and strongest tendon in the body.
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BACKGROUND & OBJECTIVE

The Achilles Tendon (AT) is treated with the most restrictive level of protection post-injury and post-surgery of any tendon. It is the largest and strongest tendon in the body (1). Post op periods are characterized by restricting mechanical load on the AT through a dorsiflexion limiting orthoses (or boot) for up to 8 weeks and restricting single leg heel raises and jumping until 4 months.

Exercise is the most efficacious conservative treatment for Achilles tendinopathy. Heavy slow resistance training has been shown to reduce pain and improve AT mechanical stiffness (2). Strength is a top priority in post op AT rehabilitation as well. Clinicians must be familiar with how exercise selection affects the mechanical load on the AT to optimally prescribe and progress exercise.

The authors of this paper sought to compare the normative values of AT load during various exercises commonly used in rehabilitation to better inform prevention and rehabilitation approaches.

The Achilles Tendon is treated with the most restrictive level of protection post-injury and post-surgery of any tendon.
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Vertical jumps have been shown to utilize more quadriceps muscle and less calf muscle than horizontal jumps, however vertical landings, require significantly more Achilles Tendon load than horizontal landing.

METHODS

The authors performed a systematic review under PRISMA guidelines. 11 articles were included. Eligibility criteria included assessment of a living human and evaluation of the internal and relative load on the AT in either healthy or injured participants.

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