Achilles Tendinopathy- Shock-wave Therapy, Dry Needling, or Exercise oriented Rehab: What Works
Best?
Achilles Tendinopathy- can be defined as a common injury to the tendon connecting the calf muscle
to the heel as a result of overuse. It is very frequent among athlete, runners and individual with
active lifestyle. Nowadays various treatment procedures are available to target this condition
including Shock-wave Therapy, Dry Needling, or Exercise oriented Rehab, which leads to one
common question- Which of the following works best? So, lets discuss this here:
1. Extracorporeal Shock-wave Therapy (ESWT)
It incorporates transmission of sound waves of low energy to the tendon which in turn mitigates pain,
accelerate healing as well as boosts blood flow to the target area. It’s a non-invasive approach and is
effective in chronic cases with no to minimal complicacies. Evidence have shown promising output of
this approach when combined with a properly structured loading program. However, this approach
might take few sessions to show results. Also, availability and cost might be other barriers.
2. Dry Needling
In this fine needles are inserted into the targeted muscle or tendon to facilitate repairing, bring down
the tension, and ease pain. It contributes in lowering tightness in the muscle which further results in
enhanced mobility and functionality. Evidence suggests short term results from this therefore needs
to be incorporated with rehabilitation program. Shortcomings includes invasive approach, temporary
soreness and bruising and variation in the effectiveness from person to person.
3. Exercise-oriented Rehabilitation
It incorporates a structured loading program, which encompass isometric and eccentric exercises in
order to strengthen the tendon and to assist in remodeling while targeting the root cause of the
problem. Researches have shown that eccentric exercise are very effective treatment option as it
leads to long term improvement but needs consistency, time, guidance of physiotherapist.
So, which treatment comes out on top?
One approach doesn’t suits everyone. Exercise based rehabilitation program serves as the starting
platform and often can be blend with other approaches like shock-wave therapy or dry needling in
order to obtain best chance at lasting recovery.
