Shockwave Therapy for Mid‑portion and Insertional Achilles Tendinopathy - what does the evidence say?
- RRS Education
Chronic Achilles tendinopathy is characterized by pain, swelling and decreased performance and is divided into mid-portion and insertional classifications, with mid-portion being more common. Achilles tendinopathy occurs most frequently between the ages of 40-59, especially in athletes, runners in particular.
For Achilles tendinopathy, the standard of care consists of mechanical loading protocols, with recent studies concluding that different loading programs provide similar results, regardless of the type of movement. In loading programs, pain and function typically improve after 2 weeks, with results peaking at 12 weeks. However, at 5-year follow-up, about half of patients seek alternative treatment due to not responding adequately.
Extracorporeal shockwave therapy is thought to influence the pathophysiological process and decrease pain and improve function in Achilles tendinopathy. Shockwave therapy is considered to be safe and effective when combined with other treatments, but there is conflicting evidence.
No systematic reviews have included only experimental studies to review the effectiveness of shockwave therapy for mid- and insertional-Achilles tendinopathy separately. As a result, the aim of this systematic review is to synthesize the evidence from randomized controlled trials to determine the clinical effectiveness of shockwave therapy, either as a monotherapy or part of a multimodal package of care for chronic mid- and insertional-Achilles tendinopathy.
THIS WEEK'S RESEARCH REVIEW: “Shockwave Therapy for Mid‑portion and Insertional Achilles Tendinopathy”
This paper was published in Sports Medicine - Open (2022) and this Review is posted in Recent Reviews, Ankle - Foot, Modalities & Devices - Shockwave and the 2022 Archive.