STICK2IT - Understanding Why People Do or Do Not Stick With Exercise Treatment for Achilles Tendinopathy

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Conditions studied: Achilles Tendinopathy (AT), Musculoskeletal Diseases or Conditions, Adherence, Behaviour Change

In brief

Achilles tendinopathy is a common condition that causes pain and stiffness in the tendon at the back of the ankle. It can make walking, exercise, work, and everyday activities difficult. The main recommended treatment is a programme of progressive tendon-loading exercises, usually supported by an NHS physiotherapist. These exercises can help improve pain and function, but many people find them hard to continue over time. This means that, even though the treatment can work well, some people do not get the full benefit because they are unable to keep up with the exercise programme as advised. People with Achilles tendinopathy often describe worries about making the tendon worse, uncertainty about whether pain during exercise is safe, low confidence, slow progress, and difficulty fitting exercises into daily life. These challenges may be even greater for people from underserved groups, including those living with long-term health conditions, financial pressures, language barriers, or other forms of disadvantage. At present, there is limited research exploring these experiences in a structured way, especially in routine NHS care. The aim of this study is to understand what helps or makes it harder for people to stick with NHS-prescribed progressive tendon-loading exercises for Achilles tendinopathy. The study will focus particularly on the experiences of people who may be at higher risk of poor outcomes or reduced access to support. Up to 30 adults with experience of Achilles tendinopathy and previous NHS physiotherapy treatment will take part in a one-to-one interview. Interviews will last up to 45 minutes and can take place in person, online, or by telephone, depending on what suits the participant best. Participants will be asked about their experiences of living with Achilles tendon pain, being given exercise treatment, and trying to follow that treatment in everyday life. The information from these interviews will be analysed to identify the main barriers and supports affecting exercise adherence. The findings will be used to build a clearer understanding of the behavioural factors that influence whether people are able to continue with treatment. This will help inform the future development of a targeted support approach to improve adherence to exercise-based rehabilitation for Achilles tendinopathy in NHS practice. The long-term goal of the study is to help make treatment more effective, more personalised, and more suitable for people from a wide range of backgrounds, including those whose needs are often overlooked in research and healthcare design.

Key facts

Study ID

NCT07555184

Run by

East Lancashire Hospitals NHS Trust

People needed

30

Starts

2026-05-01

Expected to finish

2027-05-01

Last updated by the study team

2026-04-29

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• • Adults aged 18 years or over with lived experience of Achilles tendinopathy (AT).
• Gender representation: A purposive sample including men and women, with inclusion of non-binary participants where self-identified, aiming for broad gender representation rather than fixed quotas.
• Ethnic and cultural diversity: Purposive sampling will seek representation from diverse ethnic and cultural backgrounds, informed by local population demographics and service user profiles.
• Socioeconomic diversity: Participants will be recruited across high, mid, and low socioeconomic deprivation groups, defined using postcode-derived Index of Multiple Deprivation (IMD) tertiles (lower, middle, upper thirds of national IMD distribution). Recruitment will aim for representation across all three IMD categories rather than predefined percentages.

You may not qualify if…

• • Under 18 years of age
• Inability to confirm previous AT through either ELHT electronic medical records or through discussion with CI
• Individuals whose Achilles symptoms are due to a different primary pathology (e.g., Rheumatological, Achilles Rupture)
• Unable to provide informed consent
• Unable or unwilling to be audio-recorded.

Where it is running

• East Lancashire Hospitals Trust — Blackburn, United Kingdom

Full record on ClinicalTrials.gov

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