Introduction: Tendinopathy is the most common Achilles tendon overload injury, which causes severe pain, swelling, and stiffness. It occurs due to unsuccessful tendon healing, which leads to reduced load tolerance and a greater chance of rupture. Treatment begins with conservative treatment. If the condition of achilles tendinopathy does not improve, surgical treatment is performed. The Alfredson Protocol is a specialized exercise program for the treatment of achilles tendinopathy, which consists of simple eccentric heel drops exercises. This form of exercise does not only affect pain reduction but also improves neuromuscular control and reduces tendon strain. Purpose: To establish effectiveness of eccentric exercise training for treating achilles tendinopathy based on review of professional and scientific literature. Methods: We searched the literature in the databases PubMed, PEDro, ScienceDirect, Web of Science and COBISS +. The following keywords and their combinations were used: achilles tendinopathy, achilles tendinopathy AND eccentric exercise, achilles tendinopathy AND treatment, conservative treatment AND achilles tendinopathy. Results: Six studies were included in the literature review. Eccentric exercises were performed according to the Alfredson protocol in all studies. In all selected studies, they found a positive effect of eccentric exercise on the treatment of achilles tendinopathy. Namely, it caused a reduction in pain and symptoms, increased the range of motion of dorsiflexion and consequently improved the functioning of the individual in daily activities. They found that eccentric exercise did not affect tendon thickness and its neovascularization. Discussion and conclusion: The results show that eccentric exercise is an effective intervention to treat achilles tendinopathy, as it reduces pain, accelerates Achilles tendon regeneration, and improves the functional abilities of individuals. Exercise can also be combined with other interventions - laser therapy, shock wave therapy or massage of muscle trigger points, which further enhance its effectiveness.
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