Br J Sports Med. Published Online First: 29 January 2007. doi:10.1136/bjsm.2006.031732
Tendinopathies issue |
The effects of short term treatment strategies over 4 weeks in Achilles tendinopathy
1 Institute of Sports Medicine and Prevention, University of Potsdam, Germany
2 University Clinic of Freiburg; Dept. Sports Medicine, Germany
3 University Clinic of Freiburg, Dept. Neurology, Germany
* To whom correspondence should be addressed. E-mail: fmayer{at}uni-potsdam.de.
Accepted 8 January 2007
Abstract
Background: The therapeutic efficiency of non- surgical treatment strategies in Achilles tendinopathy (AT) have not been well clarified. Time-consuming and costly combinations of pain therapy, physiotherapy and biomechanical procedures are often applied.
Objective: To analyse the efficiency of single therapeutic regimens commonly used over a short period of 4 weeks.
Methods: 31 male runners (mileage >32km/w) with unilateral, untreated AT completed 4 weeks of either physiotherapy (10 treatments: deep frictions, pulsed ultrasound, ice, sensory motor training; [P]), wearing custom fit semi-rigid insoles [I] or without therapy [Control group C]. Before and after therapy, 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 analyzed (mean, 95% CI, repeated measures ANOVA, á=0.05).
Results: Pain was reduced to less than 50% of the baseline after physiotherapy [P] or wearing insoles [I] (p<0.05). Individual pain reduction was more than 50% (25%) in 89% (100%) of subjects in I and 55% (73%) in P. Higher eccentric plantar flexion peak torques after therapy were observed in I and P.
Conclusions: Most patients with Achilles tendinopathy experience a reduction in pain after only four weeks of differentiated, non-surgical treatment consisting of physiotherapy or semi-rigid insoles.
Key Words: Achilles tendinopathy, insoles, physiotherapy, therapy, training
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