Physio Clinic Aruba

21/08/2025

What are the latest guidelines for Achilles Tendinopathy?

Chimenti et al. (2024) published an extensive update of the Clinical Practice Guidelines (CPG) for Achilles Tendinopathy. It’s open access so I’d recommend reading it in full (reference below).

Exercise should be a first line treatment and should be combined with education about tendinopathy, pain and load management.

Rehab should be progressive and can include all contraction types - eccentric, heavy slow resistance, isometric and plyometrics where tolerated.

Those with irritable symptoms and low load tolerance may benefit from lower-level exercises initially with education and interventions to help reduce pain.

Patient’s with high load tolerance and low irritability may be able to start with higher levels of load, for example progressing from 15RM to 6RM over approximately 12 weeks (see Beyer et al. 2015).

It should be noted that in many areas there was minimal evidence or contradictory findings. In some areas, such as stretching, no evidence update was provided so previous recommendations from the 2018 CPG were retained.

Shockwave therapy was not included in this review as it was considered outside of typical scope of practice. However, Iontophoresis was included and recommended with moderate evidence (grade B) despite it not being used widely in practice.

🗣️What do you think? Anything you’d add or change?

Reference:
Chimenti RL, Neville C, Houck J, Cuddeford T, Carreira D, Martin RL. Achilles Pain, Stiffness, and Muscle Power Deficits: Midportion Achilles Tendinopathy Revision - 2024. J Orthop Sports Phys Ther. 2024 Dec;54(12):CPG1-CPG32. doi: 10.2519/jospt.2024.0302. PMID: 39611662.

03/07/2025

Rehab is often thought of as someone doing something to you – massage, cupping, needling, etc. While you might consider these helpful adjuncts, the foundation for successful rehab is actually built upon learning what you can do for yourself (oftentimes with the guidance of a clinician or coach).

Rehab and training should be represented along the same continuum. If your training looks significantly different from your rehab or your rehab looks significantly different from your training, you may want to re-evaluate your approach to one or both.

This is where exercise modifications can help. These are not to provide cheap gimmicks, quick fixes, or “corrective” exercises. Instead, they are intended to help you find an appropriate entry point to training, while reducing the risk of pain progressing into something more debilitating or long-lasting.

To learn more, click the link in our bio or search “E3 Rehab Exercise Modifications” on YouTube!



•YouTube: 
•Programs, Blogs & 1-on-1 Coaching: www.e3rehab.com

24/06/2025

07/02/2025

You give up too soon

And you're sabotaging your own improvement because of it

I know it's difficult to be patient when you're not seeing the results that you want in a time frame that you deem appropriate

Especially if you're used to other problems in your life being solved much more quickly

But in most cases, the long-term results in rehab take time

And usually much more time than is comfortable for you to accept

We are so accustomed to other problems in life being solved within seconds or minutes, so when days or weeks or months pass we become increasingly frustrated at how long our body takes to adapt, change, and heal

We commit to a plan for a few weeks or a month, then make the decision that whatever we're doing "isn't working" because we're not making large (and unrealistic) amounts of progress

Then we try to find the next "better" thing that will give us the results we're looking for faster

But then the same thing happens again

And again

And again

And the cycle continues...

This is why it's important to find a rehab professional who can give you an estimate of how long it might take to reach your long-term goals, even if it's a rough estimate

This helps set realistic expectations and will keep you from always feeling frustrated and like "nothing works"

So instead of always looking for the "big wins", track the "baby steps" or small improvements that occur on a day to day, week to week, or even month to month basis and then before you know it you'll be closer to your goal than you realize!
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🎯 If you need help putting together an 𝗜𝗡𝗗𝗜𝗩𝗜𝗗𝗨𝗔𝗟𝗜𝗭𝗘𝗗 𝗣𝗟𝗔𝗡 for your own training and/or rehab, tap on the 🔗 l*nk at the top of my page .caleb.burgess to apply to 𝘄𝗼𝗿𝗸 𝘄𝗶𝘁𝗵 𝗺𝗲 𝟭-𝗼𝗻-𝟭 𝗼𝗻𝗹𝗶𝗻𝗲 (or comment the word “𝗔𝗣𝗣𝗟𝗬” here and I’ll DM you the application form)

✅ I’ll perform a detailed assessment, put together an individualized program based on where you’re currently at and where you want to get to (your goals), and then coach you through the process of getting there
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📱 If you don’t need 1-on-1 coaching but need structure, join over 2800 others in my app, which includes 𝟭𝟬 𝗳𝘂𝗹𝗹 𝗹𝗲𝗻𝗴𝘁𝗵 𝗽𝗿𝗼𝗴𝗿𝗮𝗺𝘀 and 𝗼𝘃𝗲𝗿 𝟭𝟲𝟬 guided mobility, strength and stability routines within 𝟮𝟱 categorized sections covering the whole body

➡️ Tap on the 🔗 l*nk at the top of my page .caleb.burgess (or comment "𝗚𝗘𝗧 𝗦𝗧𝗔𝗥𝗧𝗘𝗗”) to get full access to my app 𝗙𝗥𝗘𝗘 for your first 𝟳 𝗗𝗔𝗬𝗦 and then $𝟵𝟵 for the whole year ($𝟴.𝟯𝟯/month)
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17/01/2025

25/12/2024

Wishing everyone a Merry Christmas from the PhysioClinic Team & Family! 🎅🌲

2024 was our third and busiest year yet. We work hard to be able to provide a high quality service to as many people as possible.📈🔝

We are looking forward to 2025 to keep on helping the people of Aruba achieve their health goals!🤝✅️

30/11/2024

08/11/2024

Masha pabien Edeline! 🥳

15/10/2024

There is a lot of misconception about 'lactic accid', 'lactate' or 'muscle acidification'..

Check out this informative video on what we know about it right now!

31/08/2024

Happy birthday to our legend Roly Bisslik🎂🥳❤️

Masha pabien Roly. Hopi bendicion di parti di Aruba completo🏊‍♂️🇦🇼❤

22/07/2024

Feliz Dialuna! 🙏🌞

Great Illustration showing the lateral and medial patellar ligaments😍

Most of us will know the MPFL as the primary ligamentous restraint of the patella, providing 50–60% of the restraining force against lateral displacement. https://pubmed.ncbi.nlm.nih.gov/22878653/

But as illustrated here, there are other important medial and lateral ligamentous structures as well:
▶︎ the patellofemoral ligaments (LPFL and MPFL),
▶︎ the lateral and medial patellomeniscal ligaments (LPML and MPML),
▶︎ and the lateral and medial patellotibial ligaments (LPTL and MPTL)
https://pubmed.ncbi.nlm.nih.gov/35858252/
https://pubmed.ncbi.nlm.nih.gov/29016187/

📸Illustration: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9302287/