Current Physical Therapy Management and Clinical Evaluation for Achilles Tendinopathy

Abstract

Achilles tendinopathy (AT) is common in both the general population and athletes, especially in running and jumping sports. The incidence of AT is 43% in athletes, but as high as 83% in middle-distance runners. However, 30% of patients have a sedentary lifestyle. Currently, the physical therapy (PT) is an effective conservative treatment and more widely population. Objective this review article is update the most effective physiotherapy treatment and the most validity and reliability clinical evaluation for AT. Destination is to provide physical therapist guideline for select appropriate clinical practice. The results of the literature review found that key treatment recommendation for AT is to follow an eccentric exercise protocol, which is the most common intervention for the management of functional limitations in AT. Extracorporeal shockwave therapy (ESWT) is the most commonly used next step when patients do not respond to eccentric exercise. Also, eccentric exercise combined with ESWT and eccentric exercise combined with ankle joint mobilization can improve immediately enhance their quality of life more than either treatment alone. Clinical evaluation can utilize many tools but the VISA-A questionnaire was developed as a validity and reliability assessment for AT. A limitation of the VISA-A questionnaire is that it was designed for athletes only, and so is inappropriate for the general population.3,4,8,13,16 The FAOS questionnaire has been accepted as a valid and reliable tool for evaluating foot and ankle injuries.1,14 Clinical evaluation is recommended to choose the appropriate assessment tool each patient (for the general population or athletes).