Eccentric muscle strengthening has become the primary conservative management approach for Achilles tendinopathy and popularized by the Alfredson program, however up to 45% of patients do not respond to this approach. Other loading programs such as Silbernagel-combined loading program incorporates eccentric-concentric, eccentric and then faster loading. The purpose of this blog is to review this combined loading program in the treatment of Achilles Tendinopathy.