Effects of short-term treatment strategies over 4 weeks in Achilles tendinopathy

Abstract

Background: The therapeutic efficacy of non-surgical treatment strategies in Achilles tendinopathy (AT) has not been well clarified. Time-consuming and costly combinations of treatment for pain, physiotherapy and biomechanical procedures are often applied. Objective: To analyse the efficacy of single therapeutic regimens commonly used over a short period of 4 weeks. Methods: 31 male runners (mileage .32 km/week) with unilateral, untreated AT completed 4 weeks of either physiotherapy (10 treatments: deep-friction, pulsed ultrasound, ice, sensory motor training; (P)), wearing custom fit semirigid insoles (I) or remained without treatment (control group C). Before and after treatment, all patients underwent a treadmill test and a plantar flexion strength exercise. Subjective pain (Pain Disability Index, Pain Experience Scale), as well as strength performance capacity (peak torque), was analysed (mean, 95% CI, repeated measures analysis of variance, a = 0.05). Results: Pain was reduced to ,50% of the baseline value after physiotherapy or after wearing insoles (p,0.05). Individual pain reduction was .50% (25%) in 89% (100%) of subjects in I and 55% (73%) in P. Higher eccentric plantar flexion peak torques after treatment were observed in I and P. Conclusions: Most patients with AT experience a reduction in pain after only 4 weeks of differentiated, nonsurgical treatment consisting of physiotherapy or semirigid insoles.

The Short-Term Effects of Treating Plantar Fasciitis With a Temporary Custom Foot Orthosis and Stretching

“…[17][18][19]24,35 Posterior tibialis and Achilles tendinopathies have been determined to improve from both types of arch-supporting orthoses plus exercise. 17,18,26 Orthoses provide arch support while maximizing tissue-specific strengthening to the muscle. 16 Likewise, the TCFO in the current study was used to provide arch support to offload the plantar fascia, while the stretches were used to restore and maintain normal tissue length.…”

Achilles Pain, Stiffness, and Muscle Power Deficits: Achilles Tendinitis

“…Mayer and colleagues 85 conducted a 4-week study in which they randomly assigned runners with unilateral Achilles tendinopathy to 1 of 3 groups: (1) custom semi-rigid inserts (n = 9), (2) physical therapy intervention (n = 11), or (3) to a control group (n = 8). Subjects in each group were similar in age (inserts, 35  6.7 years; physical therapy, 41  5.9 years; control, 38  4.9 years), height, weight, as well as kilometers run per week (inserts, 50  13.5; physical therapy, 50  13.6; control, 53.1  10.6).…”

Conservative treatment of chronic Achilles tendinopathy

“…However, most are not supported by randomized controlled trials. Our objective was to review the evidence found in randomized controlled trials for conservative treatment of chronic (i.e., greater than three months' duration) midportion Achilles tendinopathy (Box 1 [13][14][15][16][17][18][19][20][21][22][23] ).…”