Is heavy eccentric calf training our best option for mid-portion Achilles tendinopathy? A systematic review and meta-analysis

Introduction: Mid-portion Achilles tendinopathy (AT) is a common complaint for both athletes and sedentary individuals. Heavy eccentric calf training (HECT) is considered an effective intervention for mid-portion AT and is commonly used in both clinical practice and research. However, HECT is yet to be compared to natural history, traditional physiotherapy, sham rehabilitation and other exercise rehabilitation protocols (e.g. heavy slow resistance training and modified HECT) in a systematic review and meta-analysis. The objective of this review is to assess if HECT is more effective than natural history, traditional physiotherapy, sham rehabilitation and other exercise rehabilitation protocols for improvements in pain and function in mid-portion AT.