Effects of Alfredson and Silbernagel exercise therapy on pain, range of motion, and muscle performance among athletes with Achilles tendinopathy.

To determine the effects of Alfredson and Silbernagel exercise therapy on pain, range of motion, and muscle performance among athletes with Achilles tendinopathy.

The study design will be a Randomized Clinical Trial (RCT)

The study will be conducted in • Pakistan Sports Board, • Rangers Hospital • CMH Lahore Study duration= 12 months

Inclusion Criteria: • Both male and female athletes • Age between 18 to 30 years • Duration of playing at least 1 to 2 years • Athletes with chronic Achilles tendinopathy for more than 3 months • Participating in sports involving Achilles tendon loading (i.e., sports characterized by walking, running, and/or jumping) Exclusion Criteria: • Corticosteroid injections in the region of the Achilles tendon in the previous 12 months • Any neurological disease • History of fracture • Players having any co-morbidities • Athletes have systemic diseases that can hinder training • Any surgery in the lower limb region in the past two years

Group A (Alfredson Protocol): Participants will follow a 12-week eccentric exercise program, performed twice daily. It includes 4 exercises targeting Achilles tendinopathy: - Straight-knee eccentric heel drops - Bent-knee eccentric heel drops - Isometric holds during heel raises - Calf raises Group B (Silbernagel Protocol): Participants will follow a 12-week mixed-mode program performed once daily, focusing on concentric, eccentric, and plyometric exercises: - Isometric heel raises - Concentric + eccentric heel raises - Plyometric hopping exercises and sport-specific drills Progression is also achieved by adding a 5 kg load as tolerated in both protocols.

Data collection tools for, Pain= NPRS ROM= Goniometry Muscle performance calf raise test and hop test Achilles Tendinopathy= VISA-A questionnaire

Participants will be randomly assigned to two groups using the sealed envelope method to ensure allocation concealment and reduce bias. A set of numbered envelopes will be prepared, each containing a predetermined treatment assignment. Upon obtaining patient consent, Group A will receive Alfredson exercises, while Group B will follow the Silbernagel exercise protocol.

Blinding in this study means that participants will not be told which treatment group they are in or what treatment they will get. This will be done using the sealed envelope method, so it will be a single-blind study.

yet to be decided, as the study will be complete in next 3 months

yet to be decided, as the study will be complete in next 3 months

To all the researchers community and clinicians

For research purposes and evidence-based practice in clinics

Google Scholar and PubMed

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