Alfredson protocol for treatment of Achilles tendinosis

The Alfredson protocol is a program of eccentric heel-drop exercises for treating Achilles tendinopathies - the eccentric movement is the heel drop and so this is the movement when the exercise is benefitting the Achilles tendinopathy (and so performed slowly - see below)

• the protocol recommends completion of 180 eccentric repetitions a day (1)
  • currently, there is no strong rationale for this repetition volume
  • the Alfredson protocol requires patients to continue with the exercise even if pain is experienced
    • however, the patient is advised to stop if the pain becomes disabling

    A pragmatic description of Eccentric Exercises for Achilles tendinopathy is provided below (2,3):

    

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    • Stevens M, Tan CW. Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled. trial. J Orthop Sports Phys Ther. 2014 Feb;44(2):59-67
    • Sheffield Primary Care Trust. Eccentric training for treatment of Achilles Tendinopathy (Accessed 3/3/2020)
    • Somerset Partnership NHS Foundation Trust. Eccentric Heel Drop Exercise Protocol for mid tendon Achilles tendinopathy (Accessed 3/3/2020)