Achilles pain is prominent in runners and can become chronic if not addressed properly. This pain is caused by a gradual breakdown of the tendon over time usually due to overuse or poor mechanics. In addition the injury leads to an ingrowth of nerves to the tendon. This ingrowth sensitizes the body to feel pain at a lower threshold and can lead to this becoming a chronic injury. Traditionally these injuries have been treated with slow eccentrics with mixed success. An eccentric is the stretching portion of the rep. A study in the American Journal of Sports Medicine compared eccentric training to heavy slow resistance training for the treatment of Achilles tendinopathy.
The eccentric training group did 3 sets of 15, 7 days a week, for twelve weeks straight. The eccentrics were done for three seconds and only on the affected leg. Patients did straight leg calf raises and bent leg calf raises with body weight.
The heavy slow resistance group exercised three times a week and did a progressive program of 3x15 in week 1, 3x12 in weeks 2-3, 4x10 in weeks 4-5, 4x8 in weeks 6-8, and 4x6 in weeks 9-12. Patients did seated calf raises, straight leg calf raises on the leg press, and heel raises in the smith machine with a barbell across the back.
Each program was done for 12 weeks and at the end of the study they found something interesting, there was no difference in outcomes between the groups! So that’s the end of the story right? Well not so fast…….
It’s hard to put a value on time, but I think we can all agree that the quicker we can finish exercises the better. Participants in the study tracked the time that it took to complete their home exercise program. The eccentric group averaged 308 minutes/week while the heavy slow resistance group spend 107 minutes/week. At the end of the twelve weeks that’s a difference of 40 hours and 12 minutes, an entire work week plus a coffee break.
If you are experiencing Achilles tendinopathy I would suggest a heavy slow resistance program. Outcomes will be similar to an eccentric program but you will save a work week worth of time!
1. Beyer R, Kongsgaard M, Hougs kjær B, Øhlenschlæger T, Kjær M, Magnusson SP. heavy slow resistance versus eccentric training as treatment for achilles tendinopathy: a randomized controlled trial. Am J Sports Med. 2015;43(7):1704-11.