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Achilles Tendinopathy (AT)NCT07360873

Eccentric Exercises Versus Heel Insole Lift for Achilles Tendinopathy in Football Players

A study testing Eccentric Calf Muscle Exercises and Heel Insole Lift in people with Achilles Tendinopathy (AT), run by Adnan Hashim at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Achilles tendinopathy is a common overuse injury in football players and is associated with pain, stiffness, and reduced functional performance. Conservative treatment options such as eccentric calf muscle exercises and heel insole lifts are frequently used in rehabilitation; however, evidence comparing their… Read more about this study

Who is it for?
Ages 18 to 30 years, men only
Conditions the study is for
Achilles Tendinopathy (AT)
What is being tested?
Eccentric Calf Muscle Exercises and Heel Insole Lift
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 sitePakistan
Study dates
5 Apr 2025to 12 Aug 2025
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 30 years
  • Men only
  • No healthy volunteers
  • Adult

Who may be able to join

  • Male football players aged 18 to 30 years
  • Clinical diagnosis of Achilles tendinopathy
  • Achilles tendon pain for at least one month
  • Pain intensity of 3 or higher on the Visual Analogue Scale
  • Pain aggravated by weight-bearing activities
  • Able to understand English and complete questionnaires
  • Willing to avoid other treatments for Achilles tendinopathy during the 12-week study period

Who cannot join

  • Lower limb injury within the past 6 months
  • Previous Achilles tendon rupture or surgery
  • Chronic ankle instability
  • Recent use of eccentric exercises or heel insole lifts
  • Metabolic or endocrine disorders
  • Current use of medications other than paracetamol
  • Unwillingness to comply with the study protocol

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • FAME Football Club, Model Town, Lahore

    Lahore, Punjab Province, 54000

Other trials in Pakistan

About this study

Official title: Effect of Eccentric Exercises of Calf Muscles Versus Heel Insole Lift on Pain, Range of Motion, and Function in Football Players With Achilles Tendinopathy

Achilles tendinopathy is a common overuse injury in football players and is associated with pain, stiffness, and reduced functional performance. Conservative treatment options such as eccentric calf muscle exercises and heel insole lifts are frequently used in rehabilitation; however, evidence comparing their effectiveness remains limited.

This randomized controlled trial compared the effects of eccentric calf muscle exercises and heel insole lifts on pain, ankle range of motion, and functional outcomes in male football players with Achilles tendinopathy. Participants were randomly assigned to one of two intervention groups. One group performed a structured eccentric calf muscle exercise program, while the other group used heel insole lifts during daily activities.

Outcomes related to pain intensity, functional ability, calf muscle performance, and ankle range of motion were assessed at baseline and after completion of a 12-week intervention period. The results of this study aim to support evidence-based rehabilitation strategies for the management of Achilles tendinopathy in football players.

Read the detailed description

This study was a single-blinded, randomized controlled trial conducted after obtaining ethical approval from the institutional ethics review committee. Male football players aged 18 to 30 years with clinically diagnosed Achilles tendinopathy were recruited from football clubs in Lahore, Pakistan, using a non-probability convenience sampling technique. Participants who met the eligibility criteria were randomly allocated into two parallel intervention groups using a lottery method.

Participants in the experimental group received an eccentric calf muscle exercise program based on Alfredson's protocol. The exercises were performed on a step with the knee extended and slightly flexed to target the gastrocnemius and soleus muscles, respectively. The protocol consisted of three sets of fifteen repetitions, performed twice daily, seven days per week, over a 12-week period. Body weight was used as resistance, and additional external load was progressively added as pain decreased.

Participants in the control group were provided with prefabricated heel insole lifts and instructed to wear them continuously in their regular footwear during daily activities throughout the 12-week intervention period.

Outcome measures were assessed at baseline and after completion of the intervention period. These included pain intensity, functional ability, calf muscle endurance, and ankle dorsiflexion range of motion. The study was conducted in accordance with ethical principles, and written informed consent was obtained from all participants prior to enrollment. The findings of this study are intended to contribute to evidence-based sports rehabilitation practices for the management of Achilles tendinopathy.

Being tested
Eccentric Calf Muscle Exercises, Heel Insole Lift
Keywords
Achilles Tendinopathy, Eccentric Exercise, Heel Lift, Calf Muscle, Football Players, Sports Rehabilitation, Physiotherapy, Ankle Function

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Eccentric Calf Muscle ExercisesOther

    Eccentric calf muscle exercises were performed according to Alfredson's protocol. Participants completed three sets of fifteen repetitions, twice daily, seven days per week for 12 weeks. Exercises were performed on a step with the knee extended and flexed to target the gastrocnemius and soleus muscles. Resistance was progressively increased as pain decreased.

  • Heel Insole LiftDevice

    Participants were provided with prefabricated heel insole lifts (approximately 12 mm) based on shoe size and instructed to wear them continuously in their regular footwear during daily activities for a 12-week period.

Study groups in NCT07360873
Study groupRoleWhat they receive
Eccentric Calf Muscle Exercise GroupExperimentalParticipants assigned to this arm received a structured eccentric calf muscle exercise program based on Alfredson's protocol for the management of Achilles tendinopathy.
Receives: Other: Eccentric Calf Muscle Exercises
Heel Insole Lift GroupActive comparatorParticipants assigned to this arm were provided with heel insole lifts and instructed to use them during daily activities throughout the intervention period.
Receives: Device: Heel Insole Lift

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Functional Ability (Victorian Institute of Sports Assessment-Achilles, VISA-A)

    Functional status was assessed using the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire. Scores range from 0 to 100, with higher scores indicating better function (less severe symptoms).

    Measured: Baseline and at 12 weeks

  2. Pain Intensity (Visual Analogue Scale, VAS)

    Pain intensity was assessed using the Visual Analogue Scale (VAS), a 100-mm scale ranging from 0 (no pain) to 100 (worst imaginable pain). Higher scores indicate worse pain. Outcome is reported in millimeters (mm).

    Measured: Baseline and at 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted22 Jan 2026
  2. Study start5 Apr 2025
  3. Primary completion8 Jul 2025
  4. Study completion12 Aug 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants were randomly assigned to one of two parallel groups to receive either an eccentric calf muscle exercise program or heel insole lifts for a 12-week intervention period.
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07360873
Sponsor's protocol ID
PHRI/IREB/26/01/0035
Status last verified
Jan 2026
First submitted
13 Jan 2026
Last updated
22 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Individual participant data will not be shared because this study was conducted as an academic research project. The informed consent obtained from participants did not include provisions for public data sharing, and the dataset contains sensitive personal health information. Data will be stored securely and used only for academic and research purposes in accordance with institutional ethics approval.

Publications

  • Zhang BM, Zhong LW, Xu SW, Jiang HR, Shen J. Acupuncture for chronic Achilles tendnopathy: a randomized controlled study. Chin J Integr Med. 2013 Dec;19(12):900-4. doi: 10.1007/s11655-012-1218-4. Epub 2012 Dec 21.

    PubMed 23263998
  • van der Vlist AC, Winters M, Weir A, Ardern CL, Welton NJ, Caldwell DM, Verhaar JAN, de Vos RJ. Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials. Br J Sports Med. 2021 Mar;55(5):249-256. doi: 10.1136/bjsports-2019-101872. Epub 2020 Jun 10.

    PubMed 32522732
  • Stevens M, Tan CW. Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial. J Orthop Sports Phys Ther. 2014 Feb;44(2):59-67. doi: 10.2519/jospt.2014.4720. Epub 2013 Nov 21.

    PubMed 24261927
  • Stasinopoulos D, Manias P. Comparing two eccentric exercise programmes for the management of Achilles tendinopathy. A pilot trial. J Bodyw Mov Ther. 2013 Jul;17(3):309-15. doi: 10.1016/j.jbmt.2012.11.003. Epub 2012 Dec 12.

    PubMed 23768274
  • Siu WL, Chan CH, Lam CH, Lee CM, Ying M. Sonographic evaluation of the effect of long-term exercise on Achilles tendon stiffness using shear wave elastography. J Sci Med Sport. 2016 Nov;19(11):883-887. doi: 10.1016/j.jsams.2016.02.013. Epub 2016 Mar 11.

    PubMed 26996945
  • Silbernagel KG, Hanlon S, Sprague A. Current Clinical Concepts: Conservative Management of Achilles Tendinopathy. J Athl Train. 2020 May;55(5):438-447. doi: 10.4085/1062-6050-356-19. Epub 2020 Apr 8.

    PubMed 32267723
  • Silbernagel KG, Crossley KM. A Proposed Return-to-Sport Program for Patients With Midportion Achilles Tendinopathy: Rationale and Implementation. J Orthop Sports Phys Ther. 2015 Nov;45(11):876-86. doi: 10.2519/jospt.2015.5885. Epub 2015 Sep 21.

    PubMed 26390272
  • Shih, K.-S., Chen, P.-Y., Yeh, W.-L., Ma, H.-L., Farn, C.-J., Hou, C.-H., Peng, W.-C., & Wang, H.-K. (2021). Modified Ankle Joint Neuromechanics during One-Legged Heel Raise Test after an Achilles Rupture and Its Associations with Jumping. Applied Sciences, 11(5), 2227.

  • Radovanovic G, Bohm S, Peper KK, Arampatzis A, Legerlotz K. Evidence-Based High-Loading Tendon Exercise for 12 Weeks Leads to Increased Tendon Stiffness and Cross-Sectional Area in Achilles Tendinopathy: A Controlled Clinical Trial. Sports Med Open. 2022 Dec 20;8(1):149. doi: 10.1186/s40798-022-00545-5.

    PubMed 36538166
  • Rabusin CL, Menz HB, McClelland JA, Evans AM, Malliaras P, Docking SI, Landorf KB, Gerrard JM, Munteanu SE. Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial. Br J Sports Med. 2021 May;55(9):486-492. doi: 10.1136/bjsports-2019-101776. Epub 2020 Sep 28.

    PubMed 32988930
  • Rabusin CL, Menz HB, McClelland JA, Evans AM, Landorf KB, Malliaras P, Docking SI, Munteanu SE. Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial. J Foot Ankle Res. 2019 Mar 21;12:20. doi: 10.1186/s13047-019-0325-2. eCollection 2019.

    PubMed 30949243
  • Prudencio DA, Maffulli N, Migliorini F, Serafim TT, Nunes LF, Sanada LS, Okubo R. Eccentric exercise is more effective than other exercises in the treatment of mid-portion Achilles tendinopathy: systematic review and meta-analysis. BMC Sports Sci Med Rehabil. 2023 Jan 26;15(1):9. doi: 10.1186/s13102-023-00618-2.

    PubMed 36698184
  • O'Neill S, Watson PJ, Barry S. WHY ARE ECCENTRIC EXERCISES EFFECTIVE FOR ACHILLES TENDINOPATHY? Int J Sports Phys Ther. 2015 Aug;10(4):552-62.

    PubMed 26347394
  • Martin RL, Chimenti R, Cuddeford T, Houck J, Matheson JW, McDonough CM, Paulseth S, Wukich DK, Carcia CR. Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision 2018. J Orthop Sports Phys Ther. 2018 May;48(5):A1-A38. doi: 10.2519/jospt.2018.0302.

    PubMed 29712543
  • Maffulli N, Longo UG, Kadakia A, Spiezia F. Achilles tendinopathy. Foot Ankle Surg. 2020 Apr;26(3):240-249. doi: 10.1016/j.fas.2019.03.009. Epub 2019 Apr 18.

    PubMed 31031150

Questions about this trial

What is this clinical trial studying?

A study testing Eccentric Calf Muscle Exercises and Heel Insole Lift in people with Achilles Tendinopathy (AT), run by Adnan Hashim at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 22 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Functional Ability (Victorian Institute of Sports Assessment-Achilles, VISA-A) (time frame: Baseline and at 12 weeks). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07360873, which also lists 30 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Jan 2026.

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