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Effects of short-term treatment strategies over 4 weeks in Achilles tendinopathy
  1. Frank Mayer1,
  2. Anja Hirschmüller2,
  3. Steffen Müller1,
  4. Martin Schuberth3,
  5. Heiner Baur1
  1. 1Department of Sports Medicine, Institute of Sports Medicine and Prevention, University of Potsdam, Brandenburg, Germany
  2. 2Medical Clinic, Department of Rehabilitative and Preventive Sports Medicine, University Clinic of Freiburg, Freiburg, Germany
  3. 3Clinic of Neurology, Department of Neurophysiology, University Clinic of Freiburg, Freiburg, Germany
  1. 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}


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, α = 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.

  • 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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  • Published Online First 26 January 2007

  • Competing interests: None.