Whole-body vibration versus eccentric training or a wait-and-see approach for chronic Achilles tendinopathy: a randomized clinical trial

J Orthop Sports Phys Ther. 2013 Nov;43(11):794-803. doi: 10.2519/jospt.2013.4762. Epub 2013 Sep 9.


Study design: Randomized clinical trial.

Objectives: To test the hypothesis that whole-body vibration training results in greater improvements in symptoms and pain, structural changes, and muscle flexibility and strength of the triceps surae muscle-tendon unit than those achieved with eccentric training or with a wait-and-see approach.

Background: The potential use of vibration training for the treatment of Achilles tendinopathy has not been explored.

Methods: Fifty-eight patients (mean age, 46.0 years) with Achilles tendinopathy were randomly assigned to a 12-week intervention using whole-body vibration training, eccentric training, or a wait-and-see approach. Pain, tendon structure and path, and muscle flexibility and strength were assessed at baseline and follow-up, and compared using mixed-factor analyses of variance.

Results: Pain improvements at the midsection of the tendon were greater in the vibration- and eccentric-training groups than in the wait-and-see group (mean difference from the vibration-training group, -18.0; 95% confidence interval [CI]: -35.0, -1.1; mean difference from the eccentric-training group, -27.0; 95% CI: -50.9, -3.1). Improvements in pain at the musculotendinous junction were greater in the eccentric-training group than in the other groups (mean difference from the vibration-training group, -31.4; 95% CI: -60.7, -2.0; mean difference from the wait-and-see group, -50.2; 95% CI: -82.3, -18.1). Improvements in most participants were achieved in the vibration-training group, followed by the eccentric-training group.

Conclusion: Vibration training may be an alternative or a complementary treatment in patients who do not respond well to eccentric training, especially in those with insertional pain.

Level of evidence: Therapy, level 2b-.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Achilles Tendon*
  • Adult
  • Exercise Therapy
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Muscle Strength
  • Tendinopathy / therapy*
  • Vibration
  • Watchful Waiting