Objectives To compare eccentric exercises as proposed by Alfredson with eccentric and static exercises as proposed by Stanish in the management of Achilles tendinopathy.

Methods Patients with midportion Achilles tendinopathy for at least 3 months were included in this trial. They were sequentially allocated to receive either Alfredson's exercise programme or Stanish's exercise programme. Outcome measures were pain and function using the VISA-A score. Patients were evaluated at baseline, at the end of treatment (week 12), and six months (week 36) after the end of treatment.

Results 41 patients met the inclusion criteria. At the end of treatment, there was a rise in VISA-A score in both groups compared with baseline (p<0.05, paired t-test). There were significant differences in the VISA-A score between the groups at the end of treatment and at the 6-month follow up; Alfredson exercise programme group produced the largest effect (p<0.0005, independent t-test).

Conclusion An exercise programme based on Alfredson protocol was superior to Stanish model to reduce pain and improve function in patients with Achilles tendinopathy at the end of the treatment and at the follow-up. Further research is needed to confirm our results.