Achilles tendinopathy: A review of the current concepts of treatment

Bone Joint J. 2013 Oct;95-B(10):1299-307. doi: 10.1302/0301-620X.95B10.31881.

Abstract

The two main categories of Achilles tendon disorder are broadly classified by anatomical location to include non-insertional and insertional conditions. Non-insertional Achilles tendinopathy is often managed conservatively, and many rehabilitation protocols have been adapted and modified, with excellent clinical results. Emerging and popular alternative therapies, including a variety of injections and extracorporeal shockwave therapy, are often combined with rehabilitation protocols. Surgical approaches have developed, with minimally invasive procedures proving popular. The management of insertional Achilles tendinopathy is improved by recognising coexisting pathologies around the insertion. Conservative rehabilitation protocols as used in non-insertional disorders are thought to prove less successful, but such methods are being modified, with improving results. Treatment such as shockwave therapy is also proving successful. Surgical approaches specific to the diagnosis are constantly evolving, and good results have been achieved.

Keywords: Achilles; Insertional; Non-insertional; Tendinopathy; Treatment.

Publication types

  • Review

MeSH terms

  • Achilles Tendon*
  • Exercise Therapy / methods
  • High-Energy Shock Waves / therapeutic use
  • Humans
  • Minimally Invasive Surgical Procedures / methods
  • Tendinopathy / diagnosis
  • Tendinopathy / therapy*