Eccentric calf muscle training in non-athletic patients with Achilles tendinopathy.
OBJECTIVE
Achilles tendinopathy is prevalent in athletes, but can also affect sedentary patients. We studied the effects of eccentric exercises in sedentary non-athletic patients with Achilles tendinopathy.


METHODS
Thirty-four sedentary patients (18 males, average age 44 years, range 23-67; 16 females, average age 51 years, range 20-76; average BMI: 28.6+/-4.7, range 22.1-35.4) with a clinical diagnosis of unilateral tendinopathy of the main body of the Achilles tendon completed the VISA-A questionnaire at first attendance (39+/-S.D. 22.8) and at their subsequent visits. The patients underwent a graded progressive eccentric calf strengthening exercises programme for 12 weeks.


RESULTS
Fifteen patients (44%) did not improve with eccentric exercise regimen. Three patients improved after perintendinous injections aprotinin and local anaesthetic. Surgery was performed in seven patients as 6 months of conservative management failed to produce improvements. The overall average VISA-A scores at latest follow up was 50 (S.D. 26.5).


CONCLUSIONS
Eccentric exercises, though effective in nearly 60% of our patients, may not benefit sedentary patients to the same extent reported in athletes.
Sayana
Murali K
MK
Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Staffordshire ST4 7QB, UK.
Maffulli
Nicola
N
D000125:Achilles Tendon / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D000779:Anesthetics, Local / Q000627:therapeutic use; D007611:Aprotinin / Q000627:therapeutic use; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D052256:Tendinopathy / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome
D000779:Anesthetics, Local; D006490:Hemostatics; D007611:Aprotinin