Isometric Exercise for Achilles Tendinopathy – Potent?

Historically, Isometric exercises are recommended for athletes – especially for runners with Achilles tendonitis. A 2015 study by Ebonie Rio et al reported the presence of analgesic benefits on patellar tendon from isometric exercise. Based on positive results with patellar tendon, podiatrists have extrapolated Isometric exercises to heal the pain in Achilles tendon and rotator cuff.

Ebonie et al. (2015) reported that resistance isometric contractions protocol instantly (and up to 45 minutes later) reduced patellar tendon pain and enhanced Maximal voluntary isometric contraction (MVIC). The exercises included 5 sets for 45 seconds – at 70% MVIC but taking 2 minutes breather after each set.

Analgesic effect on Achilles Tendinopathy vs Patellar Tendinopathy

Considering the above outcome and physiotherapy practices, Seth O’Neil conducted a research study to determine if isometric exercises would produce pain relieving influence in Achilles tendinopathy.

Seth O’Neil et al, in their study of isometric exercises designed to heel Achilles tendinopathy, concluded that isometric exercises do not reduce pain in Achilles tendinopathy like it does in patellar tendinopathy.

O’Neil et al. in summary: For Achilles tendinopathy, the rating for group pain escalated by one point following the isometric exercises protocol. Patients who had limited pain had a small pain reduction. However, the patients that had excessive Achilles tendinopathy pain reported a large rise in their pain rating.

Therefore, the research denotes that Achilles tendinopathy could react in a different way to various loads in the various body areas. For example, eccentric loading protocols like Alfredson’s Protocol and heavy (but slow) resistance Isotonic exercise are helpful in healing Achilles tendinopathy.

However, patellar tendinopathy and Achilles Tendonitis Running Shoes shows a positive analgesic effect from the heavy isometric protocol.

Notably, patient’s reactions to the isometric exercises are dissimilar across the board. A small number of Achilles tendinopathy patients, despite being of limited clinical significance, reported some little pain relief from the isometric protocol. However, it is thought that the above patients could have been experiencing less pain from Achilles tendinopathy and thus any kind of loading would have helped them.

Conclusion 

Isometric exercises protocol won’t be damaging to people having Achilles tendinopathy. However, the Analgesic effect of the Isometric exercises for Achilles tendinopathy is documented to be lower compared to its effect on patellar tendinopathy. Therefore, physiotherapists should only recommend Isometric exercises as the beginning exercise for people with Achilles tendinopathy.

Therefore, as I had mentioned in an earlier post, eccentric and isotonic exercises will have a better Analgesic effect on Achilles tendinopathy compared to the Isometric exercises discussed above.