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Table 1 A summary of our management recommendations for Achilles and patellar tendinopathies and greater trochanteric pain syndrome

From: Effectiveness of Exercise Treatments with or without Adjuncts for Common Lower Limb Tendinopathies: A Living Systematic Review and Network Meta-analysis

Tendinopathy

Recommended first-line treatment

Resistant cases

Achilles tendinopathy

Isotonic exercise programme (eccentric or heavy slow resistance)

Add high-volume injection with corticosteroid

Patellar tendinopathy

Isotonic exercise programme (eccentric or moderate/heavy slow resistance)

OR

Isometric exercise programme if isotonic exercise not tolerated

Add topical glyceryl trinitrate

OR

Add hyaluronic acid injections

Greater trochanteric pain syndrome

Isotonic exercise programme (concentric and eccentric)

OR

Isometric exercise programme if isotonic exercise not tolerated

Add extracorporeal shockwave therapyRemove programme

  1. “Resistant cases” are those with minimal or no improvement of symptoms by the end of the exercise programme at 12 weeks. The recommended adjuncts for resistant cases should be added to a continuing exercise programme and not used as monotherapies