My Experience with ESWT for Insertional Achilles Tendonitis

Short update here:

Got the second ESWT treatment done earlier today. I've been doing eccentric calf everyday and have also focused a lot on ankle mobility at PT. I've seen a massive improvement so far as my achilles/heel is barely stiff in the morning when I wake up. Prior to ESWT and PT, it would take maybe 10-15 minutes of walking around for the stiffness to subside and the heel would still be painful when walking (I would rate the pain at a 5 out of 10). Now, I can jump right out of bed and within a few steps, I am walking normally and I don't feel any sort of pain while walking around the house at any point during the day.

I still do feel a bit of pain in my achilles/heel while walking up hills but the pain subsides after a short period of time (<2-3 minutes and I would rate the pain about a 2 out of 10). I have noticed that the pain is much more localized to where the achilles attaches to the heel while in the past, my entire heel would be in excruciating pain for a long period of time.

Starting to feel like I am actually turning the corner on this injury for the first time in a really long time which is so relieving. I know I still have a lot more to go in terms of recovery but it's such a good feeling being able to walk around the house without being in chronic pain. Going to start incorporating more jumping exercises next week at PT and then will likely begin running in 2-3 weeks from now if everything goes to plan.

Glad it worked for you but I tried ESWT, ultrasound, electrostim, massage, and literally every other treatment coupled with regular exercise and icing and nothing fixed mine. 3+ years of battling insertional pain and I'm finally giving up after my coming spring marathon and getting surgery.

Should be noted that I haven't run at all since my first treatment session around 3 weeks ago. I had my 3rd ESWT treatment done the other day and feel as if I am making good progress with my recovery. As for walking around, I feel completely normal and I don't feel pain anymore when walking up hills.

I went to PT twice this week and incorporated some weighted sled pushes + other plyometrics. I had the first PT session the day before the 3rd ESWT treatment session and my achilles felt good on the sled pushes but I definitely felt some pain (probably a 3 out of 10 in terms of pain) when hopping on one foot and doing some other exercises. I thought it was strange how I wouldn't feel pain with some activities but would with others and I mentioned this to my doctor when I saw him for the 3rd ESWT treatment session and he had assured me that it was completely normal for this to happen during the recovery process.

During the second PT session this week (day after 3rd ESWT treatment), sled pushes felt normal and was able to do more explosive jumping movements and felt a minor amount of pain (1 out of 10) when doing the same exercises that I did during the first PT session this week. I thankfully have access to an Alter-G treadmill at my PT and I will be running at 80% of my body weight sometime next week when I go to PT so I am looking forward to seeing how that goes.

Stumbled into this thread but my 2 cents of info with ESWT was Positive.

It was a few years ago for Chronic Plantar Fasciitis.. My foot Dr warned me it was a 50/50

chance of success. It was a total success and had immediate relief. It was black and blue for a week or so but, the acute pain in my heel bone was gone. Amazing results that worked in my favor..lesson learned... stretch your calfs.

Wrapped up my ESWT treatment the other day. I had 5 sessions with my doctor and I feel that I have made a ton of progress compared to where I was when I started.

The week after the 3rd ESWT treatment, I ran on the AlterG at PT for 10 minutes. I started off at 75% of my bodyweight and did not experience any sort of pain. It was such a bizarre feeling actually being able to run without any pain! In the next PT session, I ran at 80% of my bodyweight and felt no pain during the run but when driving home afterwards, my achilles got super sore. It was a bit sore/achy for the rest of the day but felt completely fine the next day. During the next PT session, I ran at 80% of my bodyweight for part of the run and then the rest of it at 85%. I felt a little bit of pain afterwards (maybe a 1 out of 10) but it didn't last as long. Next session I ran at 90% of my bodyweight. I felt a bit of pain (0.5 out of 10) during the run but nothing afterwards. I have a few more PT sessions and will be working up to running at 100% of my bodyweight. Right now, I am really tempted to go out for a run in my neighborhood to test it out but I am going to be patient with this.

Consensus on ESWT: Worth it. 100%. I was in pain all the time before I started ESWT. It was painful to walk up stairs and painful to walk down stairs. Even after sitting down for a bit, my achilles/heel would get so inflamed that it was hard to walk once I stood up. There were points where I never thought that this pain was going to go away but now I am at a point where I can legitimately think about training seriously again. I think the combination of ESWT and doing PT is the most effective way to get rid of this injury.

Update here:

I feel like I have stagnated a bit with my recovery. I would say I am about 90% healed at the moment. Went in for another ultrasound with the doctor that did my ESWT treatment and there was a ton of healing with the achilles in comparison to where it was when I first saw him in December. Going back for another appointment at the end of April to get a final ultrasound done on the achilles. In the meantime, I can run on days where it feels good and I think doing the StairMaster at the gym has helped tremendously.

take it EZ...no setbacks

This may not work for you, but what I found helped me was working on my hip strength

ESWT, dry needling, massage, eccentric exercises and PRP did nothing for me. Tenex made the pain significantly worse. Going on almost two years of insertional achilles tendonitis and really am feeling like giving up.

Not to take away from the point of the thread, but hip strength is something I have yet to try. How long until you noticed a difference and how much strengthening were you doing? Any specific exercises?

And to the OP, happy that you have experienced at least some improvement! It's a frustrating injury for sure, and I'm wishing you the best!

I had my first battle with insertional achillies tendinitis last year from about june till October. Was desperate, bought a legit shockwave machine for several grand, 4 small 5 minute sessions while biting a stick, completely gone. Have felt great until just now when I just picked up my 2nd lifetime bout with plantar fasciitis…. Have tried shockwave a bit so far, not as quick a turnaround yet on the PF.. :( I hate PF!!!