Chronic achilles tendinopathy: Does tendon structure change after eccentric exercises and does it matter?

Research review: Tendon structure's lack of relation to clinical outcome after eccentric exercises in chronic midportion Achilles tendinopathy (de Vos et al; JOSPT, 2012)

This week’s research paper examined the relationship between achilles tendon structure following eccentric exercises to alleviate chronic achilles tendinopathy (eccentrics are the gold standard treatment) and clinical outcomes (aka did the patient actually feel better).

Methods

23 individuals suffering from chronic achilles tendinopathy performed a 16-week eccentric calf raise program, filling out a VISA-A questionnaire (a validated questionnaire to quantify achilles pain and functionality) pre and post the program.

An experienced medical researcher performed ultrasonographic tissue characterization (UTC) to assess the tendon structure pre and post the program.

Results

The individual’s improved significantly after the 16-week training program (based on the VISA-A scores) but it was not correlated with a significant change in tendon structure (based on the UTC).

Practical takeaway

Physical change in the structure of the achilles tendon may not matter when it comes to improving achilles tendinopathy pain and function, particularly in the short-term.

This lines up with other studies on different body parts where physical changes in tissue doesn’t align with actual practical improvements.