Background/Purpose: Achilles tendinopathy (AT) is a common injury in runners and is not uncommon in sedentary individuals. This condition is often treated with eccentric loading, although many conservative treatments have been tried. One alternative treatment for Achilles tendinopathy is instrument assisted soft tissue mobilization (IASTM). The purpose of this study is to find out if IASTM is as effective at treating Achilles tendinopathy as eccentric exercise. Is IASTM as effective as eccentric loading in the treatment of AT in middle aged runners?
Case Description: A man reported to an outpatient clinic with an acutely strained calf. The patient had a quick initial recovery but returned to the clinic after reinjuring his calf. Further history and examination revealed an underlying Achilles tendinopathy. The physical therapist immediately began treatment with an eccentric loading program. As treatment progressed the patient expressed a desire for quicker results. The physical therapist suggested the use of IASTM as another treatment option.
Outcomes: The literature is mixed on the efficacy of IASTM, and some does not support eccentric exercises in the treatment of Achilles tendinopathy. However, the latest research shows clinical evidence supporting eccentric exercise and IASTM as effective treatments, with the most effective results being with the two as complimentary treatments. With the addition of IASTM to his treatment the patient began to improve in his recovery including a decrease in pain and an increase in activity measured by miles run.
Discussion: Data continues to be gathered on IASTM and its effect on tendinopathy. More research is needed to confirm the results of the few positive studies available in the literature. While data on effectiveness is gathered, there is little risk of adverse effects from the use of IASTM to treat AT.
Doctor of Physical Therapy (DPT)
Level of Degree
Rehabilitation, Achilles, tendinopathy, instrument, soft tissue, mobilization
Checketts, Asael Boone. "Instrument Assisted Soft Tissue Mobilization in the Treatment of Achilles Tendinopathy." (2018). https://digitalrepository.unm.edu/dpt/142