Eccentric Exercise Versus Eccentric Exercise and Astym for Insertional Achilles Tendinopathy

Inclusion Criteria: * diagnosis of insertional AT as a primary complaint\* * symptom duration of at least 6 weeks * VISA-A score of 78 or lower * he presence of insertional AT will be clinically determined by the primary investigator using the following criteria: pain at or within 2 cm of the posterior calcaneal insertion of the Achilles tendon along with localized tenderness and a subjective report of decreased activity levels secondary to Achilles pain. Exclusion Criteria: * prior treatment with eccentric exercise or Astym for Achilles tendinopathy * currently taking anticoagulant medication * usage of fluoroquinolone antibiotics in the previous six months * previous Achilles surgery on the involved side * bilateral symptoms * pregnancy * worker's compensation or liability cases * peripheral neuropathy * signs of lumbar radiculopathy * inability to complete the required outcomes forms or comply with the recommended treatment regimen