Click here to read our previous post on diagnosis and etiology

Many treatments are offered to patients with painful tendons, but the scientific evidence for most of the conservative and surgical treatments remains sparse. Activity modification and counselling of patient is must. In acute condition patient may need rest but in chronic case patient may not need rest and activities, which are not giving pain may be continued.

  • Manual therapy

Joint mobilisation may be done if joint restriction is found.

  • Taping :

Rigid Taping to correct the subtalar pronation may be done. Kinesio taping may also be done

https://youtu.be/goVUeVSBLEo

 

Exercise programs ( mid portion tendinopathy)

 

  • Gradual tendon loading program

 

As per = Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Continued sports activity using a pain monitoring model during rehabilitation in patients with Achilles tendinopathy. Am J Sports Med. 2007

 

Phase 1: Weeks 1-2

Patient status: Pain and difficulty with all activities, difficulty performing ten 1-legged toe raises

Goal: Start to exercise, gain an understanding of their injury and of pain-monitoring model

Treatment program: Perform exercises every day

  • Pain-monitoring model information and advice on exercise activity
  • Circulation exercises (moving foot up/down)
  • 2-legged toe raises standing on the floor (3 sets × 10-15 repetitions/set)
  • 1-legged toe raises standing on the floor (3 × 10) • Sitting toe raises (3 × 10)
  • Eccentric toe raises standing on the floor (3 × 10)

 

 Phase 2: Weeks 2-5

Patient status: Pain with exercise, morning stiffness, pain when performing toe raises

Goal: Start strengthening

Treatment program: Perform exercises every day

  • 2-legged toe raises standing on edge of stair (3 × 15)
  • 1-legged toe raises standing on edge of stair (3 × 15)
  • Sitting toe raises (3 × 15)
  • Eccentric toe raises standing on edge of stair (3 × 15)
  • Quick-rebounding toe raises (3 × 20)

 

Phase 3: Weeks 3–12 (longer if needed)

Patient status: Handled the phase 2 exercise program, no pain distally in tendon insertion, possibly decreased or increased morning stiffness

Goal: Heavier strength training, increase or start running and/or jumping activity

Treatment program:

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