The Role of Injections in the Rehabilitation of Chronic Mid-Portion Achilles Tendinopathy

Achilles mid-portion tendinopathy is defined as a painful thickening of the tendon, identified also on different imagistic examinations, occurring in sport people as well in inactively middle-aged individuals. The chronic and/or relapsing evolution interfere with daily living and alter the quality of life. Eccentric physical exercise is a cornerstone in her management and several injectable agents are used in clinical settings to reduce pain and improve function. According to the presumed pathogenic mechanisms, many classes of agents are in use: corticosteroids, protease inhibitors, sclerosing agents, pro-inflammatory agents, autologous products. The modalities of administration, either intra- or peritendon, the timing and number of sessions are displayed. The association with rest, tendon protection and eccentric exercise are underlined.