Ultrasound-based evaluation of changes in tendon macro- and micromorphology following exercise and ESWT in mid-portion Achilles tendinopathy: A randomized clinical trial with a 26-week follow-up.
Jakub Katolický, Tomáš Nedělka, Gregory Bashford et al.
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In 30 seconds
This randomized clinical trial evaluated the effects of progressive resistance training alone versus in combination with focused extracorporeal shockwave therapy (ESWT) on tendon morphology in 41 participants with chronic midportion Achilles tendinopathy. Both interventions resulted in significant pain reduction and functional improvement, with the combined group showing a significant decrease in cross-sectional area at week 26 (p = 0.031) and more pronounced micromorphological remodeling.
Key findings
- Both treatment groups experienced significant pain reduction and functional improvement (p < 0.001).
- Cross-sectional area decreased significantly only in the combined group at week 26 (p = 0.031).
- Micromorphological changes included decreased P6 and SUM, and increased PPP and Q6, indicating improved collagen organization.
Why it matters
Understanding the effects of combined therapies on tendon morphology can guide clinicians in optimizing treatment strategies for chronic Achilles tendinopathy, potentially enhancing patient outcomes through improved tendon structure and function.