Ankle Mobilization for Achilles Tendon Pain

Overseen By Scott Lowe

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Philadelphia College of Osteopathic Medicine

Must not be taking: Cortisone

Disqualifiers: Surgery, Instability, Pregnancy, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 4

38 Participants Needed

Trial Summary

What is the purpose of this trial?

The purpose of this research is to find out how pain sensation may change in the Achilles tendon after the use of manual physical therapy. The testing itself will use a device that gradually produces a sensation of heat or cold on your skin, which we will place directly over your Achilles Tendon. You will let the researcher know when the heat or cold becomes what you would describe as "slight discomfort," at which point the pressure will be stopped. Testing will be completed three (3) times in a row. The device has built-in programming which ensures that the heat or cold applied will be safe, even though it may be briefly uncomfortable. After this first testing the researchers will perform 1-3 repetitions of the ankle joint mobilization/manipulation. This technique involves the researcher providing a small quick stretching movement downwards at the ankle. This is a common therapeutic technique utilized by Physical Therapists, chiropractors, and physicians and is considered very safe. After this treatment we will perform the same measurements of hot and cold discomfort on your Achilles tendon

Research Team

Scott W Lowe

Principal Investigator

PCOM

Eligibility Criteria

This trial is for adults with heel pain in the Achilles tendon lasting over 3 months, confirmed by a clinical screen. It's not for those who've had lower extremity surgery, recent cortisone injections in the tendon, diagnosed ankle instability, are pregnant, under 18 or can't consent.

Inclusion Criteria

I have been diagnosed with Achilles tendinopathy by a doctor.

I have had pain in the back of my heel for at least 3 months.

Exclusion Criteria

Current pregnancy

I am under 18 years old.

I have had surgery below the knee on the affected leg.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

1 week

1 visit (in-person)

Baseline Testing

Standardized assessment of heat and cold pain thresholds using the Medoc TSA Air2 device

1 day

1 visit (in-person)

Intervention

Participants receive either talocrural joint manipulation or sham treatment, followed by re-testing of pain thresholds

1 day

1 visit (in-person)

Follow-up

Participants are monitored for changes in pain thresholds after intervention

1 hour

1 visit (in-person)

Treatment Details

Interventions

• Ankle mobilization
• Sham treatment

Trial Overview The study tests how manual therapy affects Achilles tendon pain. Participants will undergo heat/cold discomfort testing before and after receiving ankle mobilization—a quick stretch by a therapist—to see if there's any change in their pain sensation.

Participant Groups

Group I: Intervention Experimental Treatment 1 Intervention

Subjects assigned to the intervention group will then receive a talocrural joint high velocity, low amplitude thrush mobilization/manipulation. Standardized technique for this procedure involves the subject long-sitting with their back supported on the treatment table. The provider will then passively dorsiflex and evert the ankle to the point at which a joint tension end-feel is obtained. A small amplitude of movement is rapidly provided by the provider in a caudal direction. The provider may attempt up to three treatment thrust impulses, or until an audible cavitation is heard, indicating joint movement. Even without an audible cavitation, no more than three impulses will be provided. Some research in other body regions indicates that treatment effect is present even in those with whom audible joint cavitation is not noted.

Group II: Control Placebo Group 1 Intervention

Subjects in the control group will receive 1 minute of passive ankle movement into ankle dorsiflexion. The researcher will not move the subjects ankle into a point where tissue stretch/tension is perceived. This will serve as an appropriate sham treatment since it still involves the subjects perception of treatment and includes the hands-on element of manual therapy, without the use of any tissue intervention which would theoretically effect change.

Who Is Running the Clinical Trial?

Philadelphia College of Osteopathic Medicine

Lead Sponsor

Trials

11

Recruited

1,300+