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- Issue 56
- Physical modalities with eccentric exercise are…
Physical modalities with eccentric exercise are no better than eccentric exercise alone in the treatment of chronic achilles tendinopathy: a systematic review and meta-analysis
Key Points
- This systematic review compared eccentric exercise with eccentrics combined with physical modalities (such as shockwave, laser and Astym).
BACKGROUND & OBJECTIVE
Chronic Achilles tendinopathy is a common condition which burdens patients with pain and functional disability. The current gold standard treatment for Achilles tendinopathy (AT) is a progressive loading programme, however this certainly doesn’t lead to resolution of symptoms for all patients. ‘Adjuncts’ are often added to normal care in a hope that they will address pain and improve function, but is that actually the case?
This systematic review sought to examine if adding interventions such as shockwave, laser, night splints, orthoses or Astym (tool assisted massage) to eccentric exercise (EE) was more effective than eccentric exercise on its own for AT.
Education, activity modification, and progressive loading remain our first-choice treatments for Achilles tendinopathy.
METHODS
A systematic review and meta-analysis was conducted in line with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Key scientific databases were searched using specific search terms to identify relevant papers. This was combined with a search of