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J Can Chiropr Assoc. 2011 Dec;55(4):269-79.

Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique, ART, eccentric exercise, and cryotherapy.

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  • 1Assistant professor, Clinical Education, Canadian Memorial Chiropractic College, 6100 Leslie St., Toronto, Ontario M2H 3J1.



To describe the subjective pain and functional improvements of a patient with chronic Achilles tendinopathy following a treatment plan incorporating active and passive tissue warm-up, followed respectively by soft tissue mobilization utilizing both Graston Technique(®) and Active Release Techniques(®), eccentric exercise, and static stretching in combination with cryotherapy.


The primary characterization of chronic Achilles tendinopathy is gradual onset of pain and dysfunction focused in one or both Achilles tendons arising secondary to a history of repetitive use or excessive overload.


Conservative treatment is commonly the initial strategy for patient management. Tissue heating, soft tissue mobilization, eccentric training, and static stretching with cryotherapy were implemented to reduce pain and improve function.


A specific protocol of heat, soft tissue mobilization, eccentric exercise, stretching, and cryotherapy appeared to facilitate a rapid and complete recovery from chronic Achilles tendinopathy.


Achilles; Active Release Techniques; Graston Technique; cryotherapy; eccentric exercise; soft tissue therapy; tendinopathy; tendon pathology; thermotherapy

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