Achilles Tendinopathy (AT)
Conditions
Keywords
Achilles tendinopathy, Voodoo flossing, Tissue flossing
Brief summary
This study is a randomized controlled trial (RCT) investigating the effectiveness of tissue flossing as an adjunctive therapy for Achilles tendinopathy. Thirty participants, aged 20-45 years with a clinical diagnosis of Achilles tendinopathy (\>6 weeks), will be randomly assigned to one of two groups. The intervention group will receive a single session of tissue flossing (involving an elastic band wrapped from mid-calf to heel under moderate tension, followed by active ankle exercises) combined with conventional eccentric loading exercises. The control group will receive conventional eccentric loading exercises only. The primary outcome measures will be pain intensity, assessed using the Numeric Pain Rating Scale (NPRS); ankle range of motion, measured via the Weight-Bearing Lunge Test (WBLT); functional limitation, evaluated with the Lower Extremity Functional Scale (LEFS); and jump performance, measured by countermovement jump height using the My Jump Lab app. Assessments will be conducted at baseline, after the intervention session, and at a one-week follow-up. The study aims to determine if tissue flossing provides significant immediate and short-term improvements in pain and function, potentially offering a novel, low-cost supportive technique for rehabilitation.
Interventions
DEVICETissue flossing
The intervention group receives a single session of tissue flossing combined with conventional treatment. The flossing protocol involves applying an elastic band (50-70% tension) from the mid-calf to the heel. While wrapped, participants perform active ankle range of motion and bodyweight heel raises for 2-3 minutes. This is immediately followed by the conventional treatment: eccentric loading exercises for the gastrocnemius (knee straight) and soleus (knee flexed 45°) muscles, consisting of 2 sets of 20 repetitions with a 5-minute rest between sets.
OTHEREccentric exercises
The control group will receive conventional treatment only, which consists of a standardized eccentric exercise program for the Achilles tendon. This protocol involves performing eccentric loading exercises for both the gastrocnemius muscle with the knee held straight and the soleus muscle with the knee flexed to 45 degrees. The dosage is set at two sets of twenty repetitions for each exercise, with a five-minute rest period provided between sets. This conventional regimen will be administered in three sessions over the course of one week. Participants in this group will not receive any form of tissue flossing intervention. All outcome measures, including pain, range of motion, functional performance, and jump height, will be assessed at baseline, after each treatment session, and at the one-week follow-up to evaluate progress.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
20 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* · Adults aged 20-45 years. * Clinically diagnosed with Achilles tendinopathy for more than 6 weeks. * Ability to walk independently. * Pain on palpation of the Achilles tendon. * A pain score greater than 3/10 on the Numeric Pain Rating Scale (NPRS). * Subjective reporting of pain located 2-6 cm above the tendon's insertion into the calcaneum (heel bone). * A positive Painful Arc sign (pain localized to the tendon that moves with ankle motion). * A Body Mass Index (BMI) between 18.5 and 29.9.
Exclusion criteria
* · Systemic inflammatory diseases (e.g., rheumatoid arthritis). * A recent corticosteroid injection (e.g., within the last 3 months) or surgery related to the Achilles tendon. * Diagnosed neurological deficits. * Recent fractures in the lower limb.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Numeric Pain rating scale | From enrollment to the end of treatment at 1 week | Level of pain measured by Numeric Pain rating scale (NPRS), 0 means no pain and 10 means severe pain |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Range of motion | From enrollment to the end of treatment at 1 week | Range of motion at ankle joint measured using weight bearing lunge test |
| Counter-movement Jump Height | From enrollment to the end of treatment at 1 week | Countermovement Jump (CMJ) is a widely used, rapid, and non-invasive athletic assessment that measures lower-body explosive power, neuromuscular function, and fatigue. It involves an athlete standing upright, performing a quick downward movement (countermovement) to a self-selected depth, followed immediately by a maximal vertical jump |
| Lower Extremity Functional Scale (LEFS) | From enrollment to the end of treatment at 1 week | A 20-item, self-report questionnaire assessing the patient-perceived functional ability of individuals with lower extremity musculoskeletal conditions |
Countries
Pakistan
Contacts
PRINCIPAL_INVESTIGATORMuhammad Tayyab Iqbal, DPT
Riphah International University
Outcome results
None listed