ESWT for Mid-portion and Insertional Achilles Tendinopathy: A Systematic Review of RCTs (link.springer.com)

• Moderate evidence supports ESWT for mid-AT (VISA-A improvement exceeds MCID of 6.5).
• ESWT ineffective for ins-AT; adding to standard care may be harmful.
• Systematic review of 7 RCTs with separate analyses for mid-AT and ins-AT.

"A systematic review of RCTs evaluated the effectiveness of extracorporeal shockwave therapy (ESWT) for mid-portion (mid-AT) and insertional (ins-AT) Achilles tendinopathy separately. For mid-AT, moderate-quality evidence showed a clinically important improvement on the VISA-A (MD 9.08; 95% CI 6.35–11.81) when ESWT was added to a tendon-loading program. For ins-AT, very low-quality evidence indicated no benefit; adding ESWT to standard care even showed a negative effect (SMD −0.29; 95% CI −0.56 to −0.01)."