Merry, KohleMacPherson, Megan MBlazey, PaulFearon, AngieHunt, MichaelMorrissey, DylanNapier, ChristopherReid, DuncanWhittaker, Jackie LWilly, Richard WScott, Alex2024-02-132024-02-132024-02-05BMJ Open Sport & Exercise Medicine, ISSN: 2055-7647 (Print); 2055-7647 (Online), BMJ, 10(1), e001678-e001678. doi: 10.1136/bmjsem-2023-0016782055-76472055-7647http://hdl.handle.net/10292/17220Objective To explore clinical practice patterns of physical therapists (PTs) who treat people with Achilles tendinopathy (AT), and identify perceived barriers and facilitators for prescribing and engaging with therapeutic exercise among PTs and people with AT. Methods Two cross-sectional surveys were electronically distributed between November 2021 and May 2022; one survey was designed for PTs while the second was for people with AT. Survey respondents answered questions regarding their physical therapy training and current practice (PTs), injury history and management (people with AT), and perceived barriers and facilitators (PTs and people with AT). Results 341 PTs and 74 people with AT completed the surveys. In alignment with clinical practice guidelines, more than 94% of PTs surveyed (97% of whom had some form of advanced musculoskeletal training) prioritise patient education and therapeutic exercise. Patient compliance, patient knowledge, and the slow nature of recovery were barriers to prescribing therapeutic exercise reported by PTs, while time, physical resources, and a perceived lack of short-term treatment effectiveness were barriers for people with AT. Conclusions Consistent with clinical practice guidelines, PTs with advanced training reported prioritising therapeutic exercise and education for managing AT. However, both PTs and people with AT identified many barriers to prescribing or engaging with therapeutic exercise. By addressing misconceptions about the time burden and ineffectiveness of exercise, and by overcoming access issues to exercise space and equipment, PTs may be able to improve intervention adherence and subsequently outcomes for people with AT.© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.http://creativecommons.org/licenses/by-nc/4.0/32 Biomedical and Clinical Sciences4201 Allied Health and Rehabilitation Science4203 Health Services and Systems3202 Clinical Sciences42 Health SciencesPhysical RehabilitationClinical ResearchRehabilitationBehavioral and Social Science7.3 Management and decision making7 Management of diseases and conditions6.7 Physical7.1 Individual care needs6 Evaluation of treatments and therapeutic interventions4 Quality Education1106 Human Movement and Sports Sciences3202 Clinical sciences4207 Sports science and exerciseJournal ArticleOpenAccess10.1136/bmjsem-2023-001678