UK Defence Rehabilitation consensus agreement for the conservative management of Achilles and patellar tendinopathy: a modified Delphi approach

Achilles and patellar tendinopathy are common in military personnel due to the repetitive high loads and challenging extrinsic risk factors associated with the demands of their role. Sports medicine is rapidly evolving. Up-to-date evidence-based research is essential, alongside clinical reasoning, t...

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Bibliographic Details
Published in:BMJ military health 2025-01, p.e002893
Main Authors: Judd, Alice, Wild, K, Puxley, L, Barker-Davies, R
Format: Article
Language:English
Subjects:
Agreements
Consensus statement
Delphi method
Military Personnel
Musculoskeletal disorders
Pain
Patient satisfaction
Rehabilitation
REHABILITATION MEDICINE
SPORTS MEDICINE
Steroids
Ultrasonic imaging
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Summary:Achilles and patellar tendinopathy are common in military personnel due to the repetitive high loads and challenging extrinsic risk factors associated with the demands of their role. Sports medicine is rapidly evolving. Up-to-date evidence-based research is essential, alongside clinical reasoning, to deliver best-practice treatment to service personnel, underpinned by the duty of care to their long-term career.The aim of this research was to develop recommendations on conservative management of Achilles and patellar tendinopathy in relation to the military population. A systematic review was conducted by a multidisciplinary clinical panel from across Defence Rehabilitation. The panel was split into four subgroups (diagnosis and outcome measures, medical, exercise and adjuncts). Each subgroup proposed recommendations for voting across the wider authorship in a modified Delphi process. 28 recommendations achieved substantial agreement following a chaired meeting attended by all authors. A summary infographic was produced to highlight themes relevant to the military patient population.Diagnosis of Achilles and patellar tendinopathy remains clinical. The consensus panel strongly advocates exercise rehabilitation as the primary management of Achilles and patellar tendinopathy. Medical interventions should respect the long-term occupational needs of the military population. Education is advised, but further adjunctive interventions should only be considered on a case-by-case basis. This consensus agreement provides a framework for the development of local guidelines for the management of Achilles and patellar tendinopathy in the UK military population.
ISSN:2633-3767
2633-3775
2633-3775
DOI:10.1136/military-2024-002893