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In 2013, our group published a systematic review of Achilles and patellar tendinopathy rehabilitation programmes.1 Eccentric loading involving slow lengthening muscle contractions was, and among many still is, regarded as the first choice rehabilitation option for these lower limb overuse conditions. The rise in popularity followed Hakan Alfredson’s 1998 publication demonstrating 100% return to preinjury function with isolated eccentric loading in Achilles tendinopathy.2 This publication has had 1072 citations in Google Scholar in February 2018.
However, subsequent studies were not all able to replicate these impressive outcomes. For example, Sayana et al3 reported that up to 45% with Achilles tendinopathy did not respond to isolated eccentric loading (defined as less than a 10% change in a disease-specific pain and function outcome).
The objective of our 2013 …
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