Manual therapy and eccentric exercise in the management of Achilles tendinopathy

Jayaseelan, Dhinakar J.; Kecman, Michael; Alcorn, Daniel; Sault, Josiah D.

doi:10.1080/10669817.2016.1183289

Cited by 16 publications

(3 citation statements)

References 55 publications

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“…The inclusion of MT targeted at both local and distant locations in this study yielded AT patients' recovery. However, the limitation was that incorporating joint mobilization into routine AT therapy requires more investigation [18].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of the Graston Technique and Alfredson Protocol in the Management of Achilles Tendinopathy

Qureshi,

Hameed,

Umar

et al. 2024

Cureus

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Section: Discussionmentioning

confidence: 99%

A Comparative Study of the Graston Technique and Alfredson Protocol in the Management of Achilles Tendinopathy

Qureshi,

Hameed,

Umar

et al. 2024

Cureus

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“…30 Studies specific to tendinopathies describe exercise therapy, specifically eccentric exercise, as an effective component of an exercise program in treating individuals with tendinopathy. [31][32][33] Respondents agreed A second noteworthy finding was the lack of agreement among respondents on interventions within the dry needling theme and the manual therapy subthemes of thrust manipulation and soft tissue techniques (Table 3). Respondents reached consensus on non-thrust manipulation interventions to the glenohumeral joint, cervical and thoracic spines, scapulothoracic and acromioclavicular joints and thrust manipulation interventions to the cervicothoracic regions (Figure 2) but did not meet the a priori consensus of 75% for thrust manipulation of the glenohumeral joint or cervical spine.…”

Section: Discussionmentioning

confidence: 99%

Physical Therapy Interventions for the Management of Biceps Tendinopathy: An International Delphi Study

McDevitt

Cleland

Addison

et al. 2022

International Journal of Sports Physical Therapy

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Background Shoulder pain related to the long head of the biceps tendon (LHBT) tendinopathy can be debilitating and difficult to treat especially in athletes who often elect for surgical intervention. Conservative management is recommended but there are limited established guidelines on the physical therapy (PT) management of the condition. Hypothesis/Purpose The purpose of this study was to establish consensus on conservative, non-surgical physical therapy interventions for individuals with LHBT tendinopathy using the Delphi method approach. Study Design Delphi Study Methods Through an iterative process, experts in the PT field rated their agreement with a list of proposed treatment interventions and suggested additional interventions during each round. Agreement was measured using a four-point Likert scale. Descriptive statistics including median and percentage agreement were used to measure agreement. Data analysis at the end of Round III produced, by consensus, a list of PT interventions recommended for the management of individuals with LHBT tendinopathy. Consensus was defined as an a priori cutoff of ≥75% agreement. Results The respondent group included 29 international experts in the PT management of individuals with shoulder pain. At the conclusion of the study 61 interventions were designated as recommended based on consensus amongst experts and 9 interventions were not recommended based on the same criteria, 15 interventions did not achieve consensus. Conclusion There is a lack of well-defined, PT interventions used to treat LHBT tendinopathy. Expert respondents reached consensus on multimodal interventions including exercise, manual therapy and patient education to manage LHBT tendinopathy. Level of Evidence 5

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“…The content of the physiotherapy sessions depended on the individual physiotherapist and was documented in a training diary. The applied physiotherapy consisted mainly of massage, mobilization of soft tissue and joints, and to a lesser extent of friction and electrical stimulation. In addition, some of the patients were instructed to engage in active physiotherapeutic exercises, which they performed self‐organized at home, while recording their activities in their training diary: a randomly chosen third of patients performed eccentric exercises according to the Alfredson protocol, consisting of three sets of 15 heel drops with bended and three sets of 15 heel drops with straight knee performed twice daily; a randomly chosen second third of patients performed heavy slow resistance training of the plantar flexors, consisting of five series of four isometric plantar flexions (four times per week) with 90% of the maximum voluntary contraction held for 3 seconds with 3 seconds rest between repetitions .…”

Section: Methodsmentioning

confidence: 99%

Interleukin‐6 levels drop after a 12 week long physiotherapeutic intervention in patients with Achilles tendinopathy—a pilot study

2019

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For many years, tendinopathies were considered to be mainly degenerative. However, recent research indicates that chronic inflammation may be a feature of Achilles tendinopathy. Thus, the aim of this study was to investigate, if plasma levels of the inflammatory cytokine interleukin‐6 (IL‐6) are elevated in patients with chronic Achilles tendinopathy and if IL‐6 levels are affected by physiotherapeutic treatment, duration of symptoms or anatomical localization. Male patients with chronic insertional (n = 16) or mid‐portion (n = 15) Achilles tendinopathy were subjected to a physiotherapeutic intervention for 12 weeks. VISA‐A scores and blood plasma IL‐6 levels were determined before and after the intervention. From pre to post, VISA‐A scores (57 ± 13 to 74 ± 18 points) increased while mean plasma IL‐6 levels decreased significantly (2.5 ± 1.6 to 1.9 ± 0.7 ng/L). Patients with insertional did not significantly differ from patients with mid‐portion Achilles tendinopathy. Of all investigated parameters, pre‐ and post‐IL‐6 levels correlated weakly with age only (r = 0.388 and r = 0.389). In a subgroup of patients, inflammation appears to play a role in the context of Achilles tendinopathies, making IL‐6 a potential target for therapeutic interventions in this subgroup. Common factors leading to elevated IL‐6 levels need to be identified in future studies.

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Manual therapy and eccentric exercise in the management of Achilles tendinopathy

Abstract: Case series. Therapy, Level 4.

Cited by 16 publications

References 55 publications

A Comparative Study of the Graston Technique and Alfredson Protocol in the Management of Achilles Tendinopathy

A Comparative Study of the Graston Technique and Alfredson Protocol in the Management of Achilles Tendinopathy

Physical Therapy Interventions for the Management of Biceps Tendinopathy: An International Delphi Study

Interleukin‐6 levels drop after a 12 week long physiotherapeutic intervention in patients with Achilles tendinopathy—a pilot study

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