The Alfredson Protocol Eccentric for Achilles tendinopathy is an exercise program for people with Mid-portion Achilles tendinopathy (AT). Â
It comprises bent-leg and straight-leg heel drops while the athlete is at one edge of a step.Â
Dr. HÃ¥kan Alfredson talked about it in detail in these running shoes for Achilles tendonitis. It uses the idea of progressive eccentric loading for the Achilles tendon to enhance the tendonâ€™s ability to bear stressors and forces â€“ treating the Achillesâ€™ tendinopathy.
Whatâ€™s the Efficacy of Alfredson Protocol Eccentric for Achilles tendinopathy?
A randomized studyÂ by Alfredson et al. reported that 82 percent of participants who undertook an eccentric exercise for Achilles tendinopathy had positive outcomes at 12 weeks.
Further, another 6-week program of eccentric stretching showed positive efficacy.Â In short: Eccentric tendon loading happens when the tendon and muscles contract as youâ€™re lengtheningÂ the muscle.
Alfredson Protocol: 12-Week Eccentric Loading Program
The Alfredson protocol is composed of two distinct exercises for the treatment of Achillesâ€™ tendinopathy.
- Straight Knee – 3 x 15 repetitions twice every day
- Bent Knee – 3 x 15 repetitions twice every day
All youâ€™ll require for the exercises is a small step â€“ on which youâ€™ll step while youâ€™re exercising. However, you must consult with your physical therapist to determine if itâ€™s safe for you to exercise and if we can do the exercises correctly.
Suitable running shoes for Achilles tendinopathy must be included some of the modifiable risk factors for tendinopathy pain.
Phase I: Â Straight-legged heel drops
- Stand on the step but having your footâ€™s balls on the stepâ€™s edge. Therefore, in this position, youâ€™ll have your heels hang over the edge of the exercise step.
- Ensure you hold onto a strong object to gain the required stability and balance.
- Important for this first exercise phase to keep both of your knees in a straight position.
- With both feet, lift the heels to rise to your feetsâ€™ balls.
- Maintain the foot with the Achillesâ€™ tendinopathy soreness/ pain on the exercise step while lifting the uninjuredÂ foot off from the exercise step.
- Next, gradually lower your body using the injured ankle. Â Ensure as the heel moves down towards the floor, you maintain your footâ€™s ball remains in contact with the edge of your exercise step.
- Finally, get back the uninjured foot to the exercise step and repeat – Perform three sets of 15 repetitions.Â
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Phase I: Â Eccentric loading with bent knees
- After completing the three sets of 15 repetitions when your knees are straight on the exercise step, now repeat the protocol but with the knees bent slightly. In this position, youâ€™ll be loading the soleus muscle (calf muscle).
- Equally, repeat the exercise for three sets of 15 repetitions. Now total youâ€™ll have completed 180 repetitions daily.
- Repeat the two Alfredson protocol exercises twice daily â€“ morning and evening.
You might feel pain on your calf muscles or soreness at the back of your ankles next to the Achillesâ€™ tendon.
However, the pain will reduce as you continue exercising week after week â€“ but discontinue if the pain if unmanageable â€“ in which case youâ€™ll need to see your doctor.Â
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Continue with the exercise protocol for 12 weeks to best outcomes. Over the 12 weeks, you may consult a physical therapist to determine when you can go back to your regular workout and sports such as running. Check the Shoes for HIIT Training.Â
For example, the physical therapist could recommend plyometric exercises or balance exercisesÂ so that you can both jump and run without re-injuring your Achilles tendon.