Extracorporeal Shockwave Therapy and Platelet-Rich Plasma for Midportion Achilles Tendinopathy

Midportion Achilles tendinopathy is a common cause of pain and functional limitation in both athletes and the general population. Progressive tendon loading programs are considered first-line treatment but do not lead to satisfactory outcomes in all patients. Extracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) injections are commonly used interventions for refractory symptoms, yet evidence supporting their combined use is limited particularly in treating Achilles tendon disorders. This randomized controlled trial will evaluate the effectiveness of a standardized exercise program alone or in combination with PRP injection, ESWT, or both therapies in active adults with midportion Achilles tendinopathy. Participants will be randomized to one of four treatment groups and followed for six months. The primary outcome will assess changes in Achilles tendon symptoms and function using the Victorian Institute of Sport Assessment-Achilles (VISA-A) score. Secondary outcomes will include patient-reported outcomes, physical function testing, ultrasound tendon structure measures, and gait biomechanics.

NCT Number	NCT07483320
Lead Sponsor	Spaulding Rehabilitation Hospital Collaborators: Storz Medical AG, Foundation for Physical Medicine and Rehabilitation
Conditions	Achilles Injuries Tendon, Achilles Tendinopathy (AT), Achilles Tendinitis, Left Leg, Achilles Tendinitis, Right Leg, Achilles Tendon Pain, Achilles Tendonitis
Enrollment	100 participants
Start Date	2026-08-01
Primary Completion	2027-11-30 (estimated)
Study Completion	2028-05-30 (estimated)
Updated on ClinicalTrials.gov	2026-07-27