Table A2.
Exercise and return-to-running program.
| Eccentric calf exercise program |
| Exercise 1: Gastrocnemius Heel Drop Hold onto something stable for balance. Begin with the heel raised and knee straight Slowly lower the heel below the step Push up to the starting position by using the uninjured leg Perform 3 × 15 repetitions, 2 × daily, 7 days/week. |
| Exercise 2: Soleus Heel Drop Hold onto something stable for balance. Begin with heel raised and knee bent Slowly lower the heel below the step Push up to the starting position by using the uninjured leg Perform 3 × 15 repetitions, 2 × daily, 7 days/week What Should I Expect to Feel After the Exercise? When performed properly, this exercise program is going to cause some tendon and muscle soreness, especially during the first one to two weeks. Studies have shown that it is a safe training program with no risk of new injuries. The soreness will become much less as you progress with the exercises over the course of weeks. Please STOP the program and contact your physician or physiotherapist if you experience significant pain or discomfort. When you can perform the exercise without experiencing any pain or discomfort, start to increase the weight. This can be achieved by using a calf raise machine, wearing a weighted back pack or vest. Add 5 kg per week until at 60 kg. |
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Physiotherapy Follow-up Protocol for Return to Running 4 week review All been given Alfredson program Hop pain less than 1–2/10 can commence running 2 times/week Shuffle-Jog warm up 5 mins on grass 3 sets of 5 run throughs 80 m (or equivalent) 50–60% pace on grass Rolling start No more than 20% increase in distance per week 3 sets 6 reps 4 sets 5 reps Should be no pain by 3rd run through Repeat over 3 weeks If pain is increased overall, rest a week, return to exercises and then recommence as above If Ok progress to 3 sessions/week (every second day) Shuffle-Jog warm up 5 mins on grass 4 sets 6 run throughs 80 m ( or equivalent) 55–65% pace on grass 4 sets 7 reps or equivalent distance (one session may be steady state) 4 sets 8 reps or equivalent distance (one session may be steady state) Repeat 3 weeks Review at 6 weeks Tailored approach to return to pre- baseline/ aspirational training loads Educational support regarding realistic goals Weekly increase limited to 7–10% increase Review at 12 weeks |