The management of mid-portion achilles tendinopathy with astym® and eccentric exercise: a case report

Mid-portion Achilles tendinopathy (AT) is a common injury among runners and recreational athletes. The conservative management of mid-portion AT typically includes eccentric exercise as recommended in multiple systematic reviews and practice guidelines. However, an eccentric program typically requires 12 weeks for satisfactory results and problems with compliance have been reported. Astym® is a non-invasive instrument assisted soft tissue treatment that can be used in the management of tendinopathies but there is limited published research on this treatment approach. The purpose of this case report is to present the management and outcomes of a patient with AT who was treated with eccentric exercise and Astym®.

The patient was a 56-year-old recreational tennis player referred to physical therapy with mid-portion AT of 6 weeks duration. Her primary complaints were pain with walking and an inability to play tennis. She was treated in physical therapy 2 times per week for 10 visits with treatment focused on Astym® and eccentric exercise.

By her 6(th) visit she subjectively reported being 75% functionally normal and was able to play a doubles tennis match. After 10 visits she reported that she was pain-free and able to play singles and doubles tennis without limitation.

The patient in this case report was able to return to her normal activities after 5 weeks of treatment with Astym® and eccentric exercise. These results were achieved in less than half of the time commonly reported with eccentric exercise alone.

This case suggests that Astym® combined with eccentric exercise may be a beneficial treatment approach for patients with AT.