A quick update for patients with this type of tendinopathy using a eccentric treatment plan as described by the researcher Alfredson.  The success rate of this type of  eccentric treatment program is less successful typically for insertional tendinopathies as compared to mid-portion tendinopathies.  If you are not having success or are just starting with the traditional program it may benefit you to limit the range of motion at the ankle.  The starting position should be from the heel on  floor to a complete heel raise.  I would avoid a full heel drop as depicted in the pictures below.  A recent pilot study demonstrated greatly improved outcomes when limiting the ankle range of motion.  Generally, I will instruct patients that they should experience some  low level discomfort/pain during this training as described in the research in order to have improvements.  These programs can take up to 12 weeks for positive results.

Heel Raise Ending Position

Heel Raise Position to Avoid

Hopefully all our athletes and weekend warriors from surrounding Paramus and Ridgewood area can benefit from the slightly different approach!