Gordon, Robert MD, FRCS(C); Chambers, Rebecca PT, MSc.
Athletic tendinitis, a misnomer, has been treated surgically and nonsurgically for many years by traditional methods. Many methods have been described, yet few have been proven by scientific evaluation. These methods are costly, time-consuming, poorly justified, and based on myth. The orthopaedic surgeon has relied on treatment such as ultrasound, laser, modallities, nonsteroidal anit-inflammatories and corticosteroids for nonsurgical treatment. The published studies have been poorly designed with few control groups, short follow-up periods, and small numbers of patients, which results in a loss of study power. Nonsurgical treatment for tendinopathies is almost always chosen over surgery. Nonoperative treatment for rotator cuff tendinitis, lateral epicondylitis, patellar tendinopathy, Achilles tendinosis, and plantar fasciitis has shown failure as high as 35%. Surgical treatment for such conditions have varied in the literature, with plantar fasciitis exhibiting a patient satisfaction as low as 48%. The reason for such variability in successful treatment and failure rate is the sparse and conflicting scientific evidence supporting the use of many common treatments. This review will outline some of the recent research results of nonsurgical and surgical treatments, and hopefully not only show a clearer picture, but shed new light on their use.