ORIGINAL ARTICLE

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

Frank Mayer¹, Anja Hirschmüller², Steffen Müller¹, Martin Schuberth³, Heiner Baur¹

¹ Department of Sports Medicine, Institute of Sports Medicine and Prevention, University of Potsdam, Brandenburg, Germany
² Medical Clinic, Department of Rehabilitative and Preventive Sports Medicine, University Clinic of Freiburg, Freiburg, Germany
³ Clinic of Neurology, Department of Neurophysiology, University Clinic of Freiburg, Freiburg, Germany

Correspondence to:
Professor Dr F Mayer
Department of Sports Medicine, Institute of Sports Medicine and Prevention, University of Potsdam, Am Neuen Palais 10, Haus 12, 14469 Potsdam, Germany; fmayer{at}uni-potsdam.de

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, = 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.

Abbreviations: AT, Achilles tendinopathy; C, control group; I, group wearing insoles; IAT, individual’s anaerobic threshold; P, group undergoing physiotherapy; PDI, Pain Disability Index; PES, Pain Experience Scale

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