Achilles pain, Achilles stiffness
Conditions
Interventions
Self-myofascial release exercises (intervention group)
In the SMR group, the participants will use a foam roller and a foam ball to self-massage the plantar aponeurosis and the calf muscles twice a d
Alfredson et al. 1998): (1) from an upright position and the body weight on the forefoot of both feet on a step, and with total plantar flexion of the ankle, the participants transfer all body weight
and (2) basically the same exercise, but now with the knee bent (maximum activation of the gastrocnemius muscle). Both eccentric exercises will be performed with three sets of 15 repetitions for each
Alfredson et al. 1998). Different velocities of execution have shown not to influence treatment outcomes (Kellis et al. 1995). The participants will be instructed to allow pain at the same amount as t
Sponsors
VU University Medical Center
Eligibility
Inclusion criteria
Inclusion criteria: Recreational runners aged 18 years or over, who have been running regularly for at least one year, suffering from self-reported Achilles tendon complaints (pain, stiffness and/or tenderness to touch).
Exclusion criteria
Exclusion criteria: Exclusion criteria are: (1) presence of severe cardiovascular, neurologic, endocrine, psychiatric, or orthopaedic diseases (except Achilles tendinopathy); (2) simultaneous participation in other studies; (3) pregnancy or nursing period; and (4) regular intake of analgesic drugs (5) symptoms to severe that they cause complete “inability to run”.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary outcomes The following primary outcomes will be assessed at baseline and post-treatment (12 weeks after baseline). VISA-A score The VISA-A questionnaire (Victorian Institute of Sports Assessment – Achilles questionnaire) is aimed at assessing the severity of Achilles tendinopathy, and it consists of eight questions covering different domains: pain; self-reported tendon stiffness; function; and activity (Robinson et al. 2001). A total score ranging from 0 to 100 is calculated based on the responses of the eight questions. Questions 1 to 7 are scored based on response alternatives varying from 0 to 10. Question 8 is scored based on response alternatives varying from 0 to 30. The VISA-A questionnaire has demonstrated good to excellent test-retest, intra-rater, and inter-rater reliability as well as sufficient construct validity (Robinson et al. 2001). A validated dutch version of the questionnaire will be used (van Sterkenburg, M.N. 2012). Mechanical pain threshold A handheld mechanical algometer (diameter of 1 cm², pdt, USA) will be used to determine the mechanical pain threshold (MPS), which represents a surrogate of the pressure sensitivity. The anatomical location of this measure will be on the Achilles tendon at the height of the lateral malleolus. Using the tip of the algometer, an investigator will apply an increasing pressure to the tendon at a rate of approximately 1 kg/cm²/s until the subject reports a painful sensation. The corresponding force value (kg/cm²) will be recorded. The lower the score (and thus mechanical pain threshold) the higher is the tenderness of the tissue in the tested area. Three measurements with 10-second time intervals will be performed. The second and the third measurement are employed for further analysis. Sufficient repeated-measures reliability of the procedure has been demonstrated by Nussbaum and Downes (1998). Self-perceived clinical progress Clinical progress will be assessed with an 11-point (-5 to +5) Global Ra | — |
Secondary
| Measure | Time frame |
|---|---|
| A web-based log will be developed in order to collect data on: (1) running exposure (hours/week, km/week, and times/week); (2) level of pain during running assessed with an 11-point NRS (0 to 10); (3) VISA-A-score; (4) self perceived clinical process (GROC); (5) adherence to the assigned treatment (SMR or ECC); and (6) competing interventions (performance of other interventions alongside with the assigned treatment including medication). Data on these secondary outcomes will be collected every other week throughout the study (12 weeks). | — |
Contacts
Public ContactEvert Verhagen
Department of Public and Occupational Health VU University Medical Center Van der Boechorststraat 7
Outcome results
None listed