As I have written about before, tendinopathies in the lower extremities (really all areas of the body) can be tough to treat and may take a while to respond to conservative, exercise based treatments. I still very much believe that progressive loading is the best long term solution to treating painful tendons that show signs and symptoms of tendinopathic changes and are not just acutely inflamed (i.e., tendinitis).
That being said, I am always on the lookout for possible adjunct treatments or options for those people who are just not responding how we might like to conservative care. Check out the guest post below that I recently wrote on the evidence for vs. against (I won’t spoil the read) the use of shock wave therapy to treat tendon pain:
The “Shocking” Truth About Shockwave Therapy for Tendons and Fascia
Image Above from:
Robinson D, Mitchkash M, Wasserman L, Tenforde AS. Nonsurgical Approach in Management of Tibialis Posterior Tendinopathy With Combined Radial Shockwave and Foot Core Exercises: A Case Series. The Journal of Foot and Ankle Surgery. 2020;59(5):1058-1061.