Abstract
Achilles tendinopathy is a common overuse injury in athletes, especially older athletes. This condition is difficult to treat and often becomes chronic. This evidence based review summarized the current pathophysiological principles guiding research as well as clinical practice and synthesized the search results to determine if eccentric exercises were effective in the treatment of patients with Achilles tendinopathy. Seven studies were identified, but only two were randomized clinical trials (level A evidence) with the rest controlled clinical studies or prospective cohort studies (level B evidence). Only one study reported follow-up one year beyond the intervention period. Based on a crossectinal analysis of post treatment outcomes, there was modest but significant clinical benefits following eccentric exercise training, but insufficient evidence to predict the long-term effects of eccentric exercise training for the management of Achilles tendinopathy. Although randomized clinical trials with a large subject population are still needed, eccentric exercise paired with biomedical training techniques should be integrated into treatment guidelines for patients with Achilles tendonitis.