Should we treat insertional Achilles tendinopathy differently than mid-portion? Last week, I shared a couple of studies on mid-portion Achilles tendinopathy, demonstrating high load is needed for tendon adaptations and that eccentric exercise isn’t superior to concentric exercise for pain and function.
This review and network meta-analysis assessed the clinical effectiveness of various non-surgical treatments for insertional Achilles tendinopathy. The studies included were RCTs comparing a non-surgical treatment for insertional tendinopathy with other non-surgical treatments, no intervention, or placebo control. The search yielded 9 studies with 464 total participants. For immediate pain improvement, the best treatment course was eccentric exercise plus soft tissue therapy.
This is another example of A vs. A+B, however. And, the review is only assessing short-term pain, it is not looking at strength, function, or tendon quality. The small number of trials points to the lack of research for insertional Achilles tendinopathy.
Comments