Strength & Sport Physical Therapy

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Chronic Tendon Repair Program (Heavy Slow Resistance)

PT protocol for Tendon-osis (chronic tendon issues) 3+ months of symptoms


Week 1

3x15 (3’’concentric, 3’’ eccentric)

Week 2 & 3

3x12 (3’’concentric, 3’’ eccentric)

Week 4 & 5

4x10 (3’’concentric, 3’’ eccentric)

Week 6, 7, 8

4x8 (3’’concentric, 3’’ eccentric)

Week 9, 10, 11, 12

4x6 (3’’concentric, 3’’ eccentric)


Perform: 3x/ week


Rest: 2-3 min between sets


Range of motion

  • Perform full range of motion reps if able, otherwise work within a decreased range. 


Intensity

  • On  a scale of 0-10, intensity should be about an “8”, AKA- you have 1-3 reps left in the tank

Pain: 

  • If truly a chronic tendon issue: Pain is allowed to go as high as 5/10

  • If an acute tendon issue: Keep pain minimal (1-2/10), prioritize rest


References (adapted from)

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9124646/ 

  2. https://www.michaelbraccio.com/blog/rehabilitation-exercises-for-achilles-tendinopathy 

  3. https://www.sciencedirect.com/science/article/pii/S1836955322000893#fig4