Achilles Tendinopathy

Abstract

Tendinopathy of the main body of the Achilles tendon is frequent and causes elevate morbidities both in sports and workplace. If a patient presents with Achilles tendon with a tender area of intratendinous swelling that moves with the tendon and whose tenderness significantly decreases or disappears when the tendon is put under tension, a clinical diagnosis of tendinopathy can be formulated. Eccentric exercises are superior to wait-and-see treatment and concentric exercise. There is currently no scientifically substantiated reason to believe that splinting would improve the outcome over a program of eccentric exercises. Comparable results can be obtained using eccentric loading or low-energy shock wave therapy. Eccentric loading alone or low-energy shock wave therapy alone are less effective than a combination of the two modalities. There is controversial on topical glyceryl trinitrate for the management of tendinopathy of the main body of the Achilles tendon. There is no definitive evidence whether low-level laser therapy may lead to better clinical outcome in patients undergoing a program of eccentric exercise. There is no evidence to justify a platelet rich plasma injection in patients with Achilles tendinopathy © 2012 Blackwell Publishing Ltd.