Understanding Achilles Tendinopathy for
Improved Results in Orthotic Therapy
tendon severity scores after being treated with three
ultrasound-guided intra-tendinous injections of PRP
at 2-week intervals (27). In a recent review of the
literature by Dr. Larry Oloff, platelet rich plasma
was found to be an effective alternative to invasive
procedures in several studies examining the modality
(28).
Achilles tendinopathies are common biomechanically
induced problems that occur in a wide range of age
groups and are difficult to treat. Because the primary
cause of Achilles tendinopathy is mechanical it makes
total sense that therapies directed at the root cause
would be the preferred treatment for the problem.
Stretching and strengthening exercises directed at
increasing posterior muscle group and hamstring
flexibility along with foot orthoses to reduce tendon
stress related to pronatory foot types has been shown
to be the way to go. Alternative therapies that are
invasive but stop short of open tendon procedures
such as extracorporeal shockwave therapy and platelet
rich plasm injections are the next line of defense.
Using this strategy, the majority of Achilles problems
can be effectively managed and our patients returned
to full preinjury activity. Non-surgical interventions
are the treatment of choice in most conditions
with surgery reserved for athletes and younger
age groups. Orthotic interventions are effective as
primary treatments or adjuncts to physical therapy
in