English

Abstract

In a previous uncontrolled pilot study we demonstrated very good clinical results with eccentric calf muscle training on patients with painful chronic Achilles tendinosis located at the 2-6 cm level in the tendon. In the present prospective study patients with painful chronic Achilles tendinosis at the 2-6 cm level in the tendon were randomized to treatment with either an eccentric or a concentric training regimen for the calf muscles with therapeutic ultrasound. The study included 60 patients, with 30 in each group mean age 30 years in each treatment group. The amount of pain during activity (jogging or walking) was recorded by the patients on a visual analogue scale, and patient satisfaction was assessed before and after treatment. The patients were instructed to perform their eccentric or concentric training regimen on a daily basis for 12 weeks. In both types of treatment regimen the patients were told to do their exercises despite experiencing pain or discomfort in the tendon during exercise. The results showed that after the eccentric training regimen 80% of the patients (24/30) were satisfied and had resumed their previous activity level (before injury), compared to 63% of the patients (19/30) who were treated with the concentric training regimen with therapeutic ultrasound as the common modality. The results of means of pain is (0.902) is significant, for range of motion is (0.042) which is not significant and foot ankle ability measure is (0.311) is significant after treatment with eccentric training was significantly better than after concentric training.