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Shock wave therapy for Achilles tendinopathy.
Current Reviews in Musculoskeletal Medicine 2010 November 27
Achilles tendinopathy has been reported as the most common overuse injury in sports medicine clinics (Clement et al. Am J Sports Med 12: 179-184, 1984). Standard treatment regimens include activity modification, heel lifts, arch supports, stretching exercises, nonsteroidal anti-inflammatories, and eccentric loading. There is a lack of consensus regarding treatment. Even so, most athletes will respond to this regimen. However, conservative management will prove to be inadequate for a subset of patients. When conservative therapy fails, other noninvasive treatment measures may be considered. Extracorporeal shock wave therapy (ESWT) has been used in soft-tissue disorders including lateral epicondylitis, plantar fasciitis, and calcific tendonitis of the shoulder. Conclusive evidence recommending ESWT as a treatment for Achilles tendinopathy is lacking. This article explores the role of shock wave therapy in the management of recalcitrant Achilles tendinopathy in patients attempting to avoid an invasive intervention.
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