Randomised Clinical Trial of Prolotherapy Injections and Eccentric Loading Exercises for Painful Achilles Tendinosis

INTERVENTION: Eccentric Loading Exercises ‐ The current 'gold standard' in the treatment of Achilles tendinosis. These exercises are performed twice daily for 12 weeks. Prolotherapy Injections (30% dextrose/ 0.1% lignocaine/ 0.1% ropivacaine) ‐ Administered weekly beside the tendon for no longer than 12 weeks. CONDITION: Achilles Tendinosis PRIMARY OUTCOME: Victorian Institute of Sport Assessment ‐ Achilles (VISA‐A) questionnaire: Consists of 8 questions measuring the domains of pain, stiffness, function, daily living and sporting activity. On a scale of 0‐100, the minimum clinically important difference is 20 and a trivial difference is 10. SECONDARY OUTCOME: Assessment of Cost‐Effectiveness Foot Posture Index Patient Global Impression of Change Sonographic Assessment Treatment Satisfaction INCLUSION CRITERIA: Clinical diagnosis of painful Achilles tendinosis. Pain and tenderness centred 2‐7cm from the calcaneal attachment. Pain longer than 6 weeks. Activity related painVISA‐A score less than 80 for participants involved in sport and less than 70 for participants not involved in sport.