Achilles tendinopathy is a frequent overuse disorder caused by repetitive loading of the tendon, particularly observed in athletes and middle-aged men. It is typically characterized by mid-portion pain, stiffness in the morning, and functional limitations, with structural alterations such as thickening and disrupted collagen alignment. Chronic progression often compromises performance and quality of life. Eccentric training protocols, such as the Alfredson regimen, are commonly prescribed but their standardized nature does not fully address individual variability. Alternative approaches including Heavy Slow Resistance training and progressive loading models (e.g., Silbernagel protocol) have demonstrated clinical effectiveness and higher patient adherence, yet they still apply uniform loading across the triceps surae without accounting for architectural differences. Given the heterogeneous structure of the soleus and gastrocnemii, targeted loading strategies may be required to optimize tendon adaptation. To address this, the present study employs a muscle architecture-based exercise program tailored to the functional and structural properties of each muscle. Ultrasound imaging will be used to evaluate muscle-tendon morphology, while isokinetic dynamometry and functional performance tests will quantify outcomes. Pain (VAS) and functional capacity (VISA-A) will also be assessed. This randomized controlled trial aims to compare the effectiveness of an architecture-specific program with the Alfredson protocol on tendon remodeling, strength, endurance, functional performance, and symptom reduction in individuals with non-insertional Achilles tendinopathy.
Age range
18 Years – 60 Years
Sex
ALL
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Muscle Strength and Endurance - Cybex HUMAC/NORM Isokinetic Dynamometer
Timeframe: From enrollment to the end of treatment at 12 weeks
Muscle and Tendon Architecture Measurements
Timeframe: From enrollment to the end of treatment at 12 weeks
Function - Victorian Institute of Sport Assessment-Achilles (VISA-A)
Timeframe: From enrollment to the end of treatment at 12 weeks
Muscle Elasticity - Myoton PRO
Timeframe: From enrollment to the end of treatment at 12 weeks
Single Leg Forward Hop Distance (cm)
Timeframe: From enrollment to the end of treatment at 12 weeks
Single Leg Stance Balance Time (seconds)
Timeframe: From enrollment to the end of treatment at 12 weeks
Ankle Mobility - Weight-Bearing Lunge Test
Timeframe: From enrollment to the end of treatment at 12 weeks