Pilot Investigation to Evaluate Effectiveness of Shockwave Therapy, Photobiomodulation and Physical Therapy in the Management of Non-insertional Achilles Tendinopathy

This is a randomized control study with an elective cross over. In part 1 of the study participants will be randomized into one of three treatment arms: 1) physical therapy only; 2) physical therapy and shockwave therapy; 3) physical therapy, shockwave therapy and photobiomodulation. At 3 months, patients can choose to switch to a different treatment arm than they were initially randomized.

Inclusion criteria

• A diagnosis of mid-portion Achilles tendinopathy (including both unilateral and bilateral)
• Running is the pre-injury primary form of physical activity and pre-injury would complete on average 10 miles per week or more of running
• VISA-A <80 at baseline to be eligible

Exclusion criteria

• Less than 3 months of symptoms
• Primary insertional Achilles tendinopathy
• Diagnosis of rheumatological disease/connective tissue condition, symptomatic arthritis of foot and ankle, a primary running related injury outside Achilles tendinopathy, other contraindications to PBMT or SWT
• Have received SWT within the past 3 months to their Achilles
• Prior injection within 3 months
• Currently enrolled in PT for more than 4 weeks for their condition
• Women who are pregnant.
• known history of Achilles tendon tear
• currently taking oral steroid or fluoroquinolone class of antibiotics