The effect of eccentric calf muscle training and surgical treatment was evaluated on a 100-mm visual analog scale, on which the patients described the amount of pain during activity (running) before (week 0) and after the eccentric training regimen (week 12) or surgical treatment (week 24). In the group that had eccentric calf muscle training, there was a significant decrease (P $ 0.001) in the pain score (from 81.2 ! 18.0 to 4.8 ! 6.5) from week 0 to week 12. In the control group (surgical treatment), there was a significant decrease (P $ 0.01) in the pain score (from 71.8 ! 17.9 to 21.2 ! 11.4) from week 0 to week 24. All patients were satisfied and back at their preinjury levels at week 12 and week 24, respectively.a