Research Article| Volume 58, ISSUE 4, P617-622, July 2019

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Extracorporeal Shock Wave Therapy Plus Rehabilitation for Insertionaland Noninsertional Achilles Tendinopathy Shows Good Results Across a Range of Domains of Function

  • Patrick C. Wheeler
    Address correspondence to: Patrick C. Wheeler, MBChB, FFSEM, Department of Sport and Exercise Medicine, University Hospitals of Leicester National Health Service Trust, Leicester General Hospital, Gwendolen Road, Leicester, LE5 4PW, United Kingdom.
    Consultant, Sport & Exercise Medicine, Department of Sport and Exercise Medicine, University Hospitals of Leicester National Health Service Trust, Leicester, United Kingdom

    Senior Clinical Academic Fellow, School for Sport, Exercise and Health Sciences, Loughborough University, Loughborough, United Kingdom

    Consultant, Sport & Exercise Medicine, National Centre for Sport and Exercise Medicine–East Midlands, Loughborough, United Kingdom
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Published:March 23, 2019DOI:


      Achilles tendinopathy, both insertional and noninsertional, is a common cause of posterior ankle pain. Although the condition of most patients improves with simple conservative measures, a proportion will go on develop chronic symptoms. This study examines the outcomes of patients following extracorporeal shock wave therapy plus a home exercise program. This prospective case series study involves a total of 39 patients, with a mean follow-up duration of 163 (range 65 to 385) days. This has demonstrated significant benefits in pain, stiffness, and a range of measures of local and global function. Median (interquartile range [IQR]) values for average self-reported pain improved from 6.5 of 10 (IQR 5.0 to 7.8) at baseline to 3.5 of 10 (IQR 2.0 to 5.1) at 3 months and to 2.0 of 10 (IQR 0.6 to 4.8) at 6 months for patients with insertional Achilles tendinopathy. This compares to improvements from 7.0 of 10 (IQR 7.0 to 8.0) at baseline to 6.0 of 10 (IQR 5.6 to 6.8) at 3 months and to 6.0 of 10 (IQR 3.0 to 7.0) at 6 months for patients with noninsertional Achilles tendinopathy. Statistically significant improvements were seen in insertional tendinopathy across a range of outcome measures; however, these were less apparent for patients with noninsertional tendinopathy. Despite these figures, no significant differences were seen in the outcomes for patients with insertional and noninsertional tendinopathy. Despite the improvements seen in the aspects of pain and function, physical activity levels had not increased following the treatment.

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