Study Design: Prospective, randomized, controlled intervention trial. Objectives: Compare outcomes between eccentric exercise and eccentric exercise plus Astym for subjects with insertional Achilles tendinopathy (AT). Background: Eccentric exercise is commonly used in the management of AT but its effectiveness for insertional AT has been quesioned. Manual soft tissue interventions, such as Astym, have been proposed to be beneficial in the treatment of AT, and it is plausible that Astym combined with eccentric exercise could result in better outcomes than eccentric exercise alone. Methods: Sixteen subjects were randomly assigned to either an Astym and eccentric exercise group or an eccentric exercise only group. Intervention was completed over a 12-week period with outcomes assessed at baseline, 4, 8, and 12 weeks. Outcomes included the Victorian Institute of Sport Assessment Achilles Specific Questionnaire (VISA-A), the numeric pain rating scale (NPRS), and the global rating of change (GROC). Results: A significant group x time interaction effect was found for the VISA-A with greater improvements noted in the Astym group. A significant main effect of time was found for the NPRS with both groups improving over the 12-week period. A significantly greater number of subjects in the Astym grou achieved a successful outcome as measured by the GROC. Conclusion: Astym plus eccentric exercise was more effective than eccentric exercise only at improving function while both groups experienced similar improvements in pain. The combined treatment group was more likely to obtain a successful outcome.
