Seventy-six patients with insertional Achilles tendinopathy were randomized to receive three sessions of radial extracorporeal shockwave therapy (n=38) or sham therapy (n=38), alongside identical education and exercise. The primary outcome was the Victorian Institute of Sports Assessment–Achilles (VISA-A) questionnaire. Secondary outcomes included worst pain (VAS), physical activity, kinesiophobia, pain catastrophizing, pain self-efficacy, and quality of life. Outcomes were assessed at 6 and 12 weeks. Overall, the results revealed no significant between-group differences in primary or secondary outcomes at either time point. These findings suggest that shockwave therapy does not provide additional benefit over sham when combined with exercise and education in this population.