Achilles Tendons

Seth is an Associate Professor at the University of Leicester. PhD on Achilles Tendinopathy (tendon disorders) and still studying/learning.

[Achilles Tendons @Seth0Neill]

How to test calf strength (plantarflexors) and it's relevance to Achilles tendons and sport.
A thread🧵

[Running-Physio @tomgoom]

Can shockwave immediately reduce tendon pain?

Research from Alsulaimani et al. (2026) would suggest not! Overall reduction in movement evoked pain was small and failed to reach the minimal clinically important difference of 1.5 points. Radial shockwave appears no more effective than sham for immediate changes in pain.

Reference:
Alsulaimani B, Perraton L, Bourke J, Powers T, Malliaras P. Does radial shockwave therapy lead to immediate improvements in pain in people with insertional Achilles tendinopathy? A randomised controlled trial. Clin Rehabil. 2026 Feb;40(2):171-181. doi: 10.1177/02692155251394951. Epub 2025 Nov 27. PMID: 41308020; PMCID: PMC12816402.

[Samuel Briggs-Price @SBP_Physio]

What should you be doing for ATR rehab …. Our Delphi paper investigating optimal rehabilitation will be coming soon

[Samuel Briggs-Price @SBP_Physio]

If you want to know the clinicians side of the story, then look at our recently published interview paper with clinicians
https://t.co/XTHQSdOb5k

[Samuel Briggs-Price @SBP_Physio]

then past 12 months
https://t.co/63TMcXqPy3

[Samuel Briggs-Price @SBP_Physio]

If you want to know the outcomes for ATR in the UK then look at our papers up to 12 months
https://t.co/tvd8xSK8xU

[Samuel Briggs-Price @SBP_Physio]

Going forward: We MUST do better to support rehabilitation following rupture …

Provide information videos….
Accessible clinician contact lines for questions …..
take in to account weight gain and mental wellbeing …
don’t discourage patients away from their goals!

[Samuel Briggs-Price @SBP_Physio]

Going forward:
- We MUST understand the varied presentations post ATR – painless low force mechanisms as well as painful high force mechanism

- We MUST understand the prescription and adherence to immobilisation protocols to properly understand the outcomes

[Samuel Briggs-Price @SBP_Physio]

Healthcare professionals were reported to discourage patients away from sport

‘They've (physiotherapist) said that I should not consider playing (badminton) because of the amount of strain that's put on (the Achilles tendon)’

[Samuel Briggs-Price @SBP_Physio]

Fear and reduced strength impact the return to activities – Which is the chicken and which is the egg?? ‘You still have it in your mind that it happened so unexpectedly so it can happen again’

[Samuel Briggs-Price @SBP_Physio]

Immobilisation had a significant impact on mental wellbeing and weight gain. Keep this in mind when considering strength to bodyweight during rehab as a one unit increase in BMI results in a three percent decrease in calf raise repetitions

[Samuel Briggs-Price @SBP_Physio]

and reported non-adherence to ‘non-weightbearing’ during the immobilisation phase

[Samuel Briggs-Price @SBP_Physio]

Standardised protocols are anything but standardised. Studies investigating outcomes MUST measure protocol adherence. Patients were casted due to A&E pressures

[Samuel Briggs-Price @SBP_Physio]

We interviewed patients after ATR managed in an NHS achilles clinic

We found that ATR’s were reported by many patients as pain free. Keep this in mind when diagnosing… as a missed/delayed diagnosis impacts long term outcomes

[Samuel Briggs-Price @SBP_Physio]

The lack of qualitative data showing what happens post ATR is crazy! We don’t have a clear picture of what the patient story is… so we found out

[Derek Griffin @DerekGriffin86]

Is heavy load really a pre-requisite for tendon adaptation?
https://t.co/jrs10FSoPS

[Samuel Briggs-Price @SBP_Physio]

PUBLICATION 📢 The experience of individuals following non-surgical management of Achilles tendon rupture in the United Kingdom – a qualitative study
…. A thread

https://t.co/e4SaC01abI

@Seth0Neill @JitMangwani @uniofleicester @footankleleics

[PeterMalliaras @DrPeteMalliaras]

Please reshare widely 🙏

Next ISTS: Boston, June 2–5, 2027 😃 (jointly with the ORS Tendon Section)

We need your help with the 2nd & final survey to shape ISTS governance and scientific committees.

Survey: https://t.co/t2NXVC45Rw

#ISTS #Tendinopathy

[Matt Kenyon @Physio_lab]

Excellent new study exploring the lived experiences of people with lower limb tendinopathy. Hoping to add to this soon with my study exploring determinants to adherence to prescribed loading exercise in Achilles tendinopathy @Seth0Neill

[Achilles Tendons @Seth0Neill]

We have two exciting new posts for lecturers at @UofLSoH which involve travel and work in China, if interested please get in touch to discuss

https://t.co/sOw7yS2CG2

[James Noake @DrJN_SportsMed]

Contributors list - i’m in good company here! 🤩🤓

@Seth0Neill @PeteOSullivanPT