From what I can gather the therapeutic effect comes from high-frequency oscillations which are present in eccentric but not concentric contractions.

I think that most people follow the eccentric only exercises as treatment due to the idea that doing the concentric part would simply load up the tendon, increase wear and tear and tighten up the calf muscles.

That is certainly why I get people to only do the eccentric part.

However, I am open to any new evidence which might change my practice.

Would you advise no riding during the 12 week period?

Onza/scholarsgate – I went through the whole 12 week eccentric thing with regular physio + ultrasound – ended up with TOPAZ radio frequency surgery 2 month non-weight bearing -followed up by months of physio – and that ankle is a lot better now – but not 100%.

I’m seeing a Dr about shockwave therapy and maybe glyceryl trinitrate patches.
Without an ultrasound scan & MRI – GP was happy to keep giving me pain pills for years (?)

I can cycle a little 10-20 easy miles – it helps. I have to use flats or mid foot cleats.

I’m surprised no one has linked to this thread in all this.

Any advice welcome though. I’m currently trying Alfredson properly having done it half heartedly in the past, coupled with icing and getting my wife to do some deep lateral massage of the Achilles and calf.

@scholarsgate I would have thought that pain would be your guide on this however last weekend has made me question this. I have had tendon and lower calf pain for a while and had 2-3 weeks off running but biking at the weekends. Biking for me is usually only around 2.5 to 3 hours but is pretty much flat out in an attempt to retain some fitness. Biking causes no symptoms whatsover.
Last week I started to feel like I was recovering and was running between 4-5 miles each day at an easy pace with only very mild symptoms and continuing to follow Gluptons excellent advice! On Saturday morning I rode for 3 hours hard with again no symptoms at all but later that day my tendon and lower calf area where a bit sore again. I ran about 5 miles pm with a slight recurrence of pain but not much. Same pattern on Sunday but with slightly more discomfort in the afternoon.
It may well be that the bike is aggravating the injury even though I am symptom free when performing it. I have decided to stay of the bike for a few weekends and see if it settles once again.

Saw a physio last night who is doing an extensive research project on ankle injury at the university he lectures at. His diagnosis was posterior ankle impingement.

Seems I might be over pointing my toes both swimming and toeing off while running.

Onzadog – good that you’ve finally got an accurate diagnosis and you can set about treating in now.

Some of you may be interested in this podcast:
BJSM interview with Alfredson