Contemporary treatments for mid-substance achilles tendinopathy: a review

Mid-substance Achilles tendinopathy is primarily a degenerative condition that frequently affects quality of life, especially for patients wanting to continue a high level of activity. It can differ from insertional Achilles tendinopathy both in terms of its epidemiology as well as its management strategies. Currently, numerous treatment options exist in the literature for this fairly common musculoskeletal condition. However, many of these treatments remain experimental with no substantial evidence for efficacy. A number of these options, including regenerative and biologic medicines, have nonetheless demonstrated improvements in patient-reported outcomes and promising potential. As such, there remains no standard approach for management beyond stretching/exercise therapy. This article reviewed the current literature surrounding treatment options and provided summaries and recommendations of eight treatment modalities for this condition. It is intended to serve as a general review as well as an objective evaluation of recent evidence that may provide some guidance for healthcare providers when discussing treatment options with patients.