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  • Writer's pictureLuke Nelson

Isometrics for tendinopathy: “𝘯𝘰𝘵 𝘢 𝘳𝘪𝘵𝘦 𝘰𝘧 𝘱𝘢𝘴𝘴𝘢𝘨𝘦”🤕⁣

Isometric exercises can be a useful tool to help with those suffering Achilles tendinopathy, but they aren't a cure all!

Since Rio’s 2015 paper, there has been an increased us of isometric exercises for treating tendinopathy. For those unsure what an isometric exercise is, it involves holding a static position for a period of time (often 40-45seconds) i.e. holding a weighted calf raise.⁣

🤓A recent systematic review & meta-analysis by Clifford et al examined the effectiveness of using isometrics in the management of tendinopathy. ⁣

🤷‍♀️What did they find? ⁣

🎯Overall, isometric exercise was found to be effective in providing pain relief and improving functional disability in tendinopathy, but there is no evidence that it is superior to isotonic exercise.⁣

🎯The lack of superiority between isometrics and isotonic exercise, may suggest that exercise type might not be as important as time under tension.⁣

🙋🏼‍♂️What is our take on this?⁣

Clinically we see isometrics work well for some patients to reduce their pain, especially in early stages of an irritable tendon, but for others they make no change or aggravate their pain. ⁣

👉Our observation also reflects Seth O’Neil’s 2018 study when he examined the effect of 45 second isometrics on pain (second image), mechanical pain pressure threshold (third image) and motor output in 16 patients with Achilles tendinopathy, and found the very same mixed results: some improved and some got worse!⁣

Key takeaway⁣

🔑As the title of this post suggests, isometrics are NOT a necessity for everyone, but can be useful for some! So for clinicians and patients alike suffering tendinopathy, try an isometric contraction, compare it to an isotonic contraction and simply do what works best!⁣

For those needing help with their tendinopathy, please don’t hesitate to contact us at


  • Clifford, C., et al. (2020). "Effectiveness of isometric exercise in the management of tendinopathy: a systematic review and meta-analysis of randomised trials." BMJ Open Sport & Exercise Medicine 6(1): e000760.⁣

  • ⁣O'Neill, S., et al. (2018). "Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy." Knee Surg Sports Traumatol Arthrosc.


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