Fifty-two participants with symptomatic mid-portion Achilles tendinopathy were randomized to receive a 12-week rehabilitation program, with additional intramuscular stimulation (IMS) (n=25), with sham intramuscular stimulation (n=19), or alone (n=8). The primary outcome of interest included the Victorian Institute of Sports Assessment–Achilles (VISA-A) score, measured at at 6, 26, and 52 weeks post-intervention. The secondary outcomes included the following: Global Rating of Change (GROC), tendon thickness, dorsiflexion range of motion both straight and bent knee, incidence of treatment success. GROC and tendon thickness were measured at 6,12, 26, and 52 weeks post-intervention, whilst range of motion scores were measured at 12 and 52-weeks post-intervention. Additional outcomes included compliance to the exercise program, and the incidence of severe adverse events. The results for the primary outcome revealed that despite no statistically significant differences found between the 3 groups at any of the timepoints, there was a statistical improvement in all scores at all timepoints from baseline (p<0.001). Furthermore, no statistically significant difference was observed between the 3 groups for treatment success, nor dorsiflexion range of motion, at all timepoints. The tendon thickness did improve from baseline at the end of the 12-weeks (p<0.01) in all treatment groups. Moreover, compliance of finishing >75% of the exercise regimen was observed in the IMS group (83%), sham IMS (92%), and the control (100%). No severe adverse events reported for any of the groups.