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The Alfredson Protocol for Achilles Tendinopathy

The Alfredson Protocol for Achilles Tendinopathy

Achilles tendinopathy is one of the most common overuse injuries that occurs globally. In 1998, Hakan Alfredson developed a specialised progressive exercise program that is commonly used today among health practitioners. This protocol uses the concept of eccentric loading of the Achilles tendon, which aims to improve its ability to withstand forces and stress. There is increasing evidence that this concept produces favourable outcomes for patients compared with other types of exercise.

What is an eccentric exercise?

Eccentric loading of a tendon occurs when the muscle and tendon are contracting as you are lengthening the muscle. This is opposite to something like a bicep curl, where the muscle is contracting while you are shortening it.

How do I perform this correctly at home?

  1. Stand on a step with the balls of your feet on the edge. Your heels should be hanging over the edge of the step
  2. Hold onto something for balance, then whilst keeping you knees straight, lift your heels and rise up onto the balls of your feet
  3. Keep your foot with the painful Achilles’ tendon on the step, and lift your non-injured foot off the step
  4. Slowly lower yourself down using your injured ankle. Your heel should move towards the floor, and the ball of your foot should remain in contact with the edge of the step
  5. Return your non-injured foot to the step and repeat the exercise

Repeat this until you have completed 3 sets of 15 repetitions, then repeat the process but this time with your knees slightly bent. Why? This places stress upon a specific muscle called the soleus, which is activated when the knee is bent. It is imperative to strengthen both of the muscles together for the successful treatment of chronic Achilles tendinopathies.

Common mistakes that are made whilst performing these exercises

  1. Lowering the injured foot towards the ground too quickly

This can actually be dangerous and may prolong the recovery time for this injury. It is extremely important to control the descent of the injured foot towards the ground while completing these exercises.

  • Step height too low

The step needs to be high enough that the heel which is being lowered does not come into contact with the ground. If this happens the Achilles tendon and calf muscles will not continually be under tension, which is a key component to performing this protocol correctly.

How long should I continue the Alfredson Protocol?

Studies have shown that this exercise program should be continued for 12 weeks to achieve optimal results.

If you are unsure whether you are performing these exercise correctly or have any other questions, come and see us in the clinic and we will be more than happy to assist you. Give us a call on 9569 5145 or book online by clicking here. Good luck with your recovery and as always, stay safe!

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