Chronic Achilles Tendinopathy in Runners: Relationship between Pain and Tendon Vascularity and Efficacy and Safety of the Radial Extracorporeal Shock Wave Therapy

Few studies report the possible correlation pain-paratendon microvascularity during the painful phase of the chronic Achilles tendinopathy and the efficacy of the radial shock wave therapy respect to other therapies. The aim of the present longitudinal, controlled study is to demonstrate the variation of the tendon micro vascularization in athletes affected by Achilles tendinopathy and the efficacy and safety of the radial extracorporeal shock wave therapy. Twelve elite runners with Achilles tendinopathy were compared with 12 healthy amateurs, both treated by radial extracorporeal shock wave therapy in 3 sessions (1/every 3 days). VAS scale was used for pain evaluation at one and six months after treatment and a Color and Power Doppler echography was performed to observe the paratendon microvascularity before the beginning of the treatment and at one and six months after. One month after the beginning of the treatment, it was observed a decrease of the hypervascularity in all 12 subjects with tendinopathy and no variation in the control group participants. Clinically, 80% of patients referred pain relief and they were able to return to sports activity. The decrease of the paratendon microvascularity confirms the correlation between the disappearance of the pain and the normalization of the vascularity in the athletes. Moreover, radial extracorporeal shock wave therapy consented a quickly pain relief and returned to the sport. These results confirmed the efficacy and safety of this physical therapy that it could be considered a good therapeutic choice in the treatment of the chronic Achilles tendinopathy.