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Midportion Achilles Tendinopathy in a National Badminton Player: HSR vs Eccentric Alfredson Protocol

Topic Summary & Background: A 23-year-old state-level singles badminton player has had 4 months of morning stiffness and localized nodular tenderness 4cm proximal to calcaneal insertion. Pain is 6/10 on first 10 minutes of lunging and hopping.

Key Discussion Questions:
  • Why Heavy Slow Resistance (HSR) produces superior collagen remodeling compared to isolated eccentric dropping?
  • Role of isometric holds (5x45 sec at 70% MVC) for immediate tendon neuroplastic analgesia?
  • What specific Hop Test battery (>90% Limb Symmetry Index) dictates return to competitive match play?
Standard Clinical Consensus: Standard Clinical Consensus: High-load isometric holds reduce cortical inhibition and provide 4-6 hours of analgesia. HSR (3 sets of 6–8 reps, 3-second concentric, 3-second eccentric, 3x/week) maximizes tendon stiffness and mechanotransduction.
DR
Dr. Rahul Deshmukh, MPT (Sports)
Sports Clinician • Just now
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