An Overview of Achilles Tendinopathy Management

Background: Persistent tendon pain and swelling related to mechanical loading are the main signs of Achilles tendinopathy (AT). This condition is one of the most common tendinopathies of the lower limb affecting mainly athletes involved in running and jumping sports. Methods: we included pivotal papers retrieved from the literature (Pubmed, Google Scholar, PEDro, and Scopus) to present an overview of the management of AT, with a specific focus on conservative management. Results: An accurate and timely diagnosis of AT is necessary to set up early treatments and to manage the problem conservatively. Diagnosis is primarily based on clinical assessment; instrumental imaging may be helpful in confirming the clinical diagnosis. Conservative treatment is effective in most cases, mainly using physical exercise based on eccentric training. Other non-surgical treatments such as extracorporeal shock wave therapy, thermotherapies, and injections can be added to exercise. Surgical treatment is indicated for patients where the conservative treatments of at least six months fails. Conclusions: Conflicting results from numerous studies hamper to identify gold standard treatments asking for further well-conducted level I and II research about the management of AT.