Table 1

Water and land based rehabilitation programme for young female athlete with Achilles tendinopathy

Rehabilitation phaseRehabilitation goalsRehabilitation programme
Early phase (1st week)Maintain cardiovascular endurancePool
Swimming interval training
Sessions 1–4 (40 min)Dorsiplantar flexionPool and land based ankle calf stretching
ROM improvement
Sessions 5–7 (50 min)Gait normalisationPool
Walking (in different stride length, depths, speeds)
Proprioception abilityPool
Ankle calf stretching
Mild static balance & isometric exercises
Wobble board training
Single leg/balance
Calf strengtheningPool
Open kinetic exercises
Dynamic strength with special equipment for all the lower limb muscle groups
Intermediate phase (2nd week)Maintain cardiovascular endurancePool
Sessions 8–14 (60 min)Swimming interval training
Increase gait endurancePool
Mild dynamic strengthening (gastrocnemius & soleus)
Gradually decreasing depths
Progressively to fully weight bearing activities, focus on Achilles tendon
Late phase (3rd week)Maintain cardiovascular endurancePool
Sessions 15–21 (60–80 min)Swimming interval training
More land based programmePool
Specific event training skillsImpact exercises
Impact exercises in grass and gradually in track and field flooring
Passive and active ankle calf stretching
Return to sport phase (4th–6th week) (60–90 min)Back to trainingLand
Progressively augmented training intensity and volume