Chronic tendinopathy is difficult to treat. Nonsurgical management is the most conservative approach. Switching to another sport (swimming, weight training, rowing, cycling) allows the tendon time to rest. Eccentric exercise therapy (exercises that cause stretching combined with contraction of a muscle) is increasingly prescribed for patients with chronic Achilles tendinopathy. Although scientific evidence does not support many traditional treatments, they are still often used and include nonsteroidal anti-inflammatory medication (eg, ibuprofen), orthoses (devices to support the muscle and relieve tendon stress; eg, heel pads), stretching, massage, ultrasound, taping the back of the leg, and plaster casting. Steroid injection directly into the tendon is sometimes used but not generally recommended because some specialists believe this increases the risk of tendon rupture. Surgery is often a last resort because recovery is slow. Although not proven, preventive measures often include choosing running shoes that provide sufficient cushion for heel strike, using a prescribed orthotic, walking and stretching to warm up calf muscles before running, gradually increasing running distance and speed by not greater than 10% per week, avoiding unaccustomed sprinting and hill running, and cooling down properly after exercise.