Effects of short-term treatment strategies over 4 weeks in Achilles tendinopathy.
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, alpha = 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, non-surgical treatment consisting of physiotherapy or semirigid insoles.
Mayer
Frank
F
Department of Sports Medicine, Institute of Sports Medicine and Prevention, University of Potsdam, Brandenburg, Germany. fmayer@uni-potsdam.de
Hirschmüller
Anja
A
Müller
Steffen
S
Schuberth
Martin
M
Baur
Heiner
H
D000125:Achilles Tendon / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D012420:Running / Q000293:injuries*; D052256:Tendinopathy / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome