Injury to the Achilles tendon is one of the most common athletic injuries, and it is no wonder, given the intense force loads the Achilles is subjected to during running and jumping. Achilles tendinopathy presents as pain, swelling and impaired function. With tendinopathy, damage to the tendon tissue is more serious than tendinitis, which is simply inflammation.
Under the umbrella of Achilles tendinopathy are distinct subcategories of injury:
The nature and onset of the injury influences the rate of healing and the choice of treatment.
Conservative treatment for Achilles teninopathy is normally effective in promoting healing and restoring function to the Achilles tendon. Eccentric loading, where workload is emphasized as the calf muscles and Achilles tendon lengthen, is universally accepted as an effective approach to treatment.
However, technology and research are continually unveiling new approaches to treatment, to be either rejected or embraced by the medical community.
Two of the more recent and advanced modes of treatment are ESWT (extracorporeal shock wave therapy) and platelet rich plasma (PRP) injections, and each has been shown to be effective in promoting recovery from Achilles tendinopathy. However, there is some controversy about the overall effectiveness of these treatments compared to conservative eccentric loading, and about whether one treatment is more effective than the other.
A number of studies have been conducted comparing the two treatment methods, along with eccentric loading, with varying and often conflicting outcomes.
However, a recent study by Erroi et al. (2017) concluded,
In most cases, a physical therapist will take a multi-modal approach to treatment of Achilles tendinopathy, employing some combination of eccentric loading, manual therapy, ESWT and PRP.
The sports medicine specialists at NYDNRehab use cutting edge therapies and treatments for Achilles tendinopathy, employing the most up-to-date technological innovations in patient care. If you suffer from pain and dysfunction in your Achilles tendon, contact NYDNRehab today and let us put you on the road to speedy recovery.
De Vos RJ, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. J Am Med Assoc. 2010;303(2):144–149.
Rompe JD, et al. Eccentric loading compared with shock wave treatment for chronic insertional Achilles tendinopathy. J Bone Joint Surg. 2008;90(1):52-61.
Sadoghi P, Rosso C, Valderrabano V, Leithner A, Vavken P. The role of platelets in the treatment of Achilles tendon injuries. J Orthop Res. 2013;31(1):111–118.