Rehabilitation

Question 1

What does Alfedson’s protocol for the treatment of Achilles tendinopathy involve?

Answer 1

12 week programme
Isolated eccentric exercise therapy
Standing heel drop (leg straight)
Standing heel drop (knee bent)
15 reps, x 3 sets, x 2 sets per day
180 reps per day
Progress by adding 5kg weights to a backpack while completing heel drop exercises

Question 2

What does Silbernagel’s rehab protocol for Achilles tendinopathy involve?

Answer 2

12 week programme
Combined concentric and eccentric exercise therapy
Standing heel drop (leg straight)
Standing heel drop (knee bent)
15 reps, x 3 sets, x 1 sets per day

Question 3

Which loading protocol produces better results in midportion Achilles tendinopathy?

Answer 3

Both have been shown to produce similar results in terms of effectiveness, as demonsrted in a recent RCT by Habets et al (2021)

Question 4

What is Baxter’s loading protocol/ index for Achilles tendinopathy rehabilitation?

Answer 4

A four tier approach to Achilles tendinopathy rehabilitation, with exercises categorised into tiers based on how much they load the Achilles tendon

Question 5

What exercises are within tier 1 of Baxter’s protocol? List them in order of ascending load

Answer 5

Seated double limb heel raises
Seated single limb heel raises
Squat
Low step up (leading leg)
High step up (leading leg)
Standing double limb heel raises

Question 6

What exercises are within tier 2 of Baxter’s protocol? List them in order of ascending load

Answer 6

Rebounding double limb heel raise
Lunge (leading leg)
Low step down (leading leg)
Low step up (trailing leg)
High step down (trailing leg)
Walk (stance)
Low step down (trailing leg)
Forward jump (2-leg)
High step down (Leading leg)
High step up (trailing leg)
Counter movement jump
Rebounding single limb heel raise
Standing single limb heel raise

Question 7

What exercises are within tier 3 of Baxter’s protocol? List them in order of ascending load

Answer 7

Drop jump (2 leg)
Hopping (2 leg)
Run (stance)
Forward hopping (2 leg)
Counter movement jump (1 leg)
Forward jump (1 leg)

Question 8

What exercises are within tier 4 of Baxter’s protocol? List them in order of ascending load

Answer 8

Hopping (1 leg)
Drop Jump (1 leg)
Lateral Hopping (1 leg)
Forward Hopping (1 leg)

Question 9

What does the DiGiovanni rehab protocol for plantar heel pain involve?

Answer 9

Stretching exercise therapy
Seated with passive dorsiflexion of 1st MTPJ
10 reps, x 10 seconds hold, x 3 times per day

Question 10

What does the Rathleff Rehab Protocol for plantar heel pain involve?

Answer 10

12 week programme
High load strength training
Combined concentric and eccentric exercise therapy
Unilateral standing heel raise (leg straight)
Toes elevated with rolled up towel
3 sec concentric, 2 sec isometric hold, 3 sec eccentric
12 reps max (RM), x 3 sets, x 2nd day x 2 weeks
10 RM x 4 sets x 2nd days x 2 weeks
8 RM x 5 sets x 2nd days x 4 weeks