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

NCT07555184 | Not Yet Recruiting

• 1 other identifier: DEV022
• Study Type: observational
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Behaviour Change; Achilles Tendinopathy (AT); Adherence; Musculoskeletal Diseases or Conditions

Keywords

Achilles tendinopathy; Theoretical Domains Framework; Qualitative; Adherence to prescribed exercise; Tendon loading exercise; Musculoskeletal physiotherapy; Behaviour change; Underserved populations; Health inequalities; Multimorbidity; Socioeconomic deprivation; Semi-structured interviews; thematic analysis

Outcome Measures

Primary Outcomes (1)

• Behavioural determinants influencing adherence to progressive tendon-loading exercise in Achilles tendinopathy

  Description: Identification of barriers and facilitators to engagement with NHS-prescribed progressive tendon-loading exercise, derived from semi-structured interview data and mapped to domains of the Theoretical Domains Framework. Time Frame: Assessed at a single time point during interview (reflecting participants' experiences within the previous 24 months).

  12 months

Secondary Outcomes (1)

• Prioritised behavioural domains for intervention development

  12 months

Study Arms (1)

Adults with Achilles Tendinopathy undertaking NHS exercise rehabilitation

This cohort includes adults with lived experience of Achilles tendinopathy who have previously received and attempted to follow a progressive tendon-loading exercise programme prescribed within NHS musculoskeletal physiotherapy services. The intervention of interest is progressive tendon-loading exercise (e.g., eccentric or heavy-slow resistance programmes), delivered as part of routine care and primarily undertaken through supported self-management. Participants will take part in semi-structured interviews exploring their experiences of engaging with and adhering to prescribed exercise, including perceived barriers and facilitators influencing adherence in real-world settings. Particular emphasis is placed on including individuals from underserved populations to capture a diverse range of experiences.

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will comprise adults aged 18 years and over with lived experience of Achilles tendinopathy who have previously received, and attempted to follow, an NHS-prescribed progressive tendon-loading exercise programme within the past 24 months. Participants will be recruited from NHS musculoskeletal service records, community engagement routes, and individuals who have previously expressed interest in Achilles tendon research. The study will use purposive sampling to achieve diversity in age, gender, ethnicity, socioeconomic background, and clinical characteristics, with particular emphasis on including underserved groups such as people living with multimorbidity, socioeconomic disadvantage, cultural or language barriers, or other factors that may affect engagement with rehabilitation.

You may qualify if:

• Adults aged 18 years or over with lived experience of Achilles tendinopathy (AT).
• 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.

Sponsors & Collaborators

• East Lancashire Hospitals NHS Trust: lead
• University of East Anglia: collaborator
• University of Leicester: collaborator

Study Sites (1)

East Lancashire Hospitals Trust

Blackburn, BB2 3HH, United Kingdom

Location

MeSH Terms

Conditions

Musculoskeletal Diseases

Central Study Contacts

Matt Kenyon, MSc Advanced Health Care

CONTACT

++447769187588; matthew.kenyon@elht.nhs.uk

Michelle Stephens

CONTACT

++447976152397; michelle.stephens@elht.nhs.uk

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 21, 2026
• First Posted: April 29, 2026
• Study Start: May 1, 2026
• Primary Completion (Estimated): September 1, 2026
• Study Completion (Estimated): May 1, 2027
• Last Updated: April 29, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share

Locations

GB (1)