Chimenti et al. 2024, Midportion Achilles tendinopathy clinical practice guideline (AOPT revision)

The third clinical practice guideline from the Academy of Orthopaedic Physical Therapy on midportion Achilles tendinopathy, revising the 2018 edition and incorporating literature through March 2024. Progressive tendon loading at the highest tolerable load — delivered as eccentric, heavy-slow resistance, isometric, or plyometric work — receives the strongest recommendation (Grade A), producing approximately 18–21 VISA-A point improvements by 12 weeks; complete rest is explicitly not indicated. Low-level laser therapy is recommended against outright; therapeutic ultrasound is recommended against as a standalone treatment. Strong (APTA consensus guideline synthesising RCTs and systematic reviews through 2024).