PTRCTBrazilian journal of physical therapy2025

The content of diagnostic information has an immediate effect on pain with loading in people with midportion Achilles tendinopathy: a randomized clinical experiment.

Nigel J Travers, Mervyn J Travers, William Gibson and 3 others

PMID 40652602

WHAT IT FOUND

Runners with Achilles tendinopathy had less pain during hopping after an explanation about lower-limb function than after an explanation about tendon structure.

The difference was 12.3 on a 0-100 pain scale.

Key findings

01Maximal pain intensity during hopping was lower after the function-focused explanation than after the structure-focused explanation (adjusted mean difference 12.3 mm, 95% CI 3.2 to 21.5).

02Vertical leg stiffness after hopping was reported as higher in the function-focused group, with an adjusted mean difference of −1546 Nm−1 (95% CI −3296 to 204).

03Time for pain to ease after hopping was near identical between groups (adjusted median difference 0 s, 95% CI −11 to 11).

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study was done at a single clinic specialising in lower-limb tendinopathy, and the same physical therapist gave all explanations, so results may not apply to other settings or clinicians. The therapist giving the explanation was not masked, so performance bias may have influenced the results. The sample size was calculated only for pain intensity, so stiffness and time-to-ease findings are exploratory and less certain. Stiffness data were missing for three participants because of equipment problems. The study measured only immediate effects after a single explanation, not longer-term pain, function, or treatment outcomes. Participants were recreational runners with unilateral mid-portion Achilles tendinopathy and VISA-A below 80, so findings may not apply to insertional tendinopathy, other activity groups, or more severe cases.

Declared interests

The authors declare no competing interest.

The easy way to misread this

Do not conclude that a function-focused explanation is a proven long-term treatment for Achilles tendinopathy. The study measured only immediate pain after a single explanation, the clinician was not masked, and the secondary stiffness and time-for-pain-to-ease results were uncertain or null.

Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →