Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial

28 patients with Achilles tendinopathy were randomized to undergo eccentric heel-drop exercises, following either a do-as-tolerated protocol or the standard Alfredson protocol. The purpose of this study was to compare the two treatment approaches with respect to pain, function and satisfaction after 6 weeks. Results indicated that both study protocols yielded significant improvements in clinical outcomes at both 3 and 6 weeks, except for the standard group at 3 weeks, wherein Victorian Institute of Sport Assessment-Achilles (VISA-A) scores had significantly deteriorated. There were no significant differences between groups in pain intensity or functional outcomes at 6 weeks. Patient satisfaction was also similar between groups.