Comparison of Alfredson and Silbernagel Protocol in Competitive Athletes With Achilles Tendinopathy

Comparison of Alfredson Eccentric and Silbernagel Concentric-eccentric Therapeutical Protocol in Competitive Athletes With Chronic Achilles Tendinopathy

A 6-week randomized clinical trial (RCT) with a 46-week follow-up compared the effect of Alfredson and Silbernagel eccentric programs for the treatment of AT. The primary outcome was a change in the Victorian Institute of Sport Assessment - Achilles (VISA-A) scale from baseline to 12 months. The study was approved by the Ethics Committee of the Faculty of Physical Education and Sport, Charles University (Project number: 254/2021). All participants provided written informed consent before participation.

Inclusion criteria:

• Athletes performing track and field, tennis or football at the competitive level
• Age 18 to 40 years
• Unilateral Achilles tendinopathy
• Pain lasting more than 2 months
• Diagnosis of Achilles tendinopathy established by pain on function at the Achilles region and ultrasound assessment (tendon thickening, swollen tendon) by one researcher
• Participants trained at least 3 times per week before the onset of Achilles tendinopathy
• Less than 3 months without training and less than 6 months from the last competition/match
• Wish to return to original sport level
• Willing to stop with other treatments 2 weeks before the start of the clinical trial

Exclusion criteria:

• Achilles tendon rupture in past
• Corticosteroid injection in Achilles tendon region in last 6 months
• Having other lower limb musculoskeletal injuries or surgery in the last 6 months (e.g., muscle rupture, bone fracture)
• Having a neurological, systemic or autoimmune disease (e.g., neuropathy, type 1 diabetes, rheumatoid arthritis)