American Board of Internal Medicine (ABIM) Certification Practice Exam

Which treatment option is recommended for managing Achilles tendinopathy?

1. Surgical repair

2. Applying heat and extensive physical therapy

3. Rest and activity modification

4. Glucocorticoid injections

The correct answer is: Rest and activity modification

Managing Achilles tendinopathy primarily focuses on conservative treatment approaches, and rest along with activity modification is essential in allowing the tendon to heal. This treatment strategy involves reducing activities that place stress on the Achilles tendon, which can exacerbate symptoms and prolong recovery. In addition to rest, activity modification might include substituting high-impact activities with lower-impact exercises (such as swimming or cycling) to maintain fitness while avoiding further injury to the tendon. This balanced approach helps alleviate pain and inflammation associated with the condition. While surgical repair may be considered in chronic cases after conservative treatments have failed, it is not the first-line recommendation for managing early or moderate cases of Achilles tendinopathy. Applying heat and extensive physical therapy can be beneficial, but overly aggressive physical therapy without initial rest can lead to further damage. Glucocorticoid injections do not typically address the underlying issues and may also have adverse effects on tendon integrity. Therefore, rest and activity modification stand out as the most effective initial management strategy for this condition.