Achilles Tendinopathy Intervention Evidence Summary (physio-pedia.com)

• Heavy-slow resistance training (HSRT) is recommended as first-line intervention for chronic Achilles tendinopathy.
• Eccentric loading is effective but may be less tolerable in reactive tendinopathy.
• Isometric exercises can be used for immediate analgesia but do not improve tendon structure.

"This toolkit section summarizes evidence and recommendations for Achilles tendinopathy interventions. Key interventions include heavy-slow resistance training (HSRT), eccentric exercises, and isometric loading for pain relief. Shockwave therapy may be considered for chronic cases. The tendon continuum model (Cook) guides load management. Outcome measures include the VISA-A questionnaire and pain scales. Return to sport is staged with strength symmetry and hop tests. The evidence supports progressive loading over passive modalities."