{"id":26744,"date":"2013-05-30T14:41:21","date_gmt":"2013-05-30T13:41:21","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=26744"},"modified":"2013-05-30T14:41:21","modified_gmt":"2013-05-30T13:41:21","slug":"domhnall-macauley-no-magic-answer-for-achilles-tendinopathy","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2013\/05\/30\/domhnall-macauley-no-magic-answer-for-achilles-tendinopathy\/","title":{"rendered":"Domhnall MacAuley: No magic answer for Achilles tendinopathy"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" alt=\"Domhnall Macauley\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/domhnall.jpg\" width=\"162\" height=\"110\" align=\"left\" \/>&#8220;<em>Although they are trendy money spinners, best evidence shows little effectiveness<\/em>\u201d\u2014An attention grabbing subheading to <a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f2979\">an editorial by Nic Maffulli<\/a> in the <em>BMJ<\/em> commenting on an intriguing randomised controlled trial (RCT) from New Zealand on the use of autologus blood injections in <a href=\"http:\/\/www.bmj.com\/content\/346\/bmj.f2310\">treating Achilles tendinopathy<\/a>. It doesn\u2019t work.<!--more--><\/p>\n<p>Evidence based sports medicine was radical new thinking when Tom Best and I first began to think about it. Care of the athlete had evolved empirically. Few asked questions. For example, when our university research group first began to study ice, perhaps the most commonly used treatment in soft tissue injury, there was little quality evidence to inform treatment; the duration of each application, over what period of time, the temperature of the ice (melting iced water is 0 degrees Celcius),\u00a0 if it mattered if you were fat or thin etc. Clinicians then began to ask about the evidence for the tests used in clinical examination, the effectiveness of prevention, the appropriate management of common conditions. Where we thought there was certainty, there was little evidence. This RCT on Achilles tendinopathy is an important trial because it asked serious questions about a treatment that had become commonplace yet seemingly evidence free.<\/p>\n<p>Much of what we think is fact in sport is hype, based often on weak science, but mostly on extrapolation from observation. People in sport are forever looking for that extra added magic ingredient to set them apart. Complicit and gullible because they want to believe.\u00a0 They follow the training programme, wear the headband, chase the logo the champions wear. It is no surprise that they take the drink, buy the supplement, wear the shoe, or do the exercise endorsed by champions. Ever susceptible, suggestible\u2014looking for an easy way, its human nature.\u00a0 So, it was no surprise to see the hype surrounding yet another product on the margin. This was the next big thing\u2014an injection to cure one of the most common and troublesome injuries.<\/p>\n<p>Its great to see good quality research and more is needed. But, research is expensive and its almost impossible to justify research in sports medicine when competing for funds with cancer, cardiology, and other core medical topics.\u00a0 There is an evidence vacuum and in sports medicine there is huge pressure to do something. And, always someone looking for the magic answer.<\/p>\n<p><strong>Domhnall MacAuley<\/strong> is primary care editor,<em> BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&#8220;Although they are trendy money spinners, best evidence shows little effectiveness\u201d\u2014An attention grabbing subheading to an editorial by Nic Maffulli in the BMJ commenting on an intriguing randomised controlled trial [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2013\/05\/30\/domhnall-macauley-no-magic-answer-for-achilles-tendinopathy\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1287,447],"tags":[],"class_list":["post-26744","post","type-post","status-publish","format-standard","hentry","category-domhnall-macauley","category-india"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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