Achilles Tendinopathy

What is Achilles Tendinopathy?

Achilles tendinopathy is a common condition that results in pain in the Achilles tendon, which is the tendon that attaches the calf muscle to the back of the heel bone. Achilles tendinopathy is caused by excess strain or load on the Achilles tendon. This can occur from an acute injury or an overuse (chronic) injury.

Once commonly known as Achilles tendonitis it is now mostly referred to as Achilles tendinopathy because research has found that it is most likely due to tendon fibre micro tears and degeneration rather than inflammation.

Sports that involve repetitive running and jumping are more prone to Achilles tendinopathy and it is estimated that it accounts for 11% of all running injuries.

Signs & Symptoms
  • Pain present in the mid-portion of the Achilles tendon (approximately 5cm from the heel insertion)
  • Pain present close to the Achilles tendon’s insertion into the heel
  • Stiffness in the tendon especially in the morning or after rest
  • Pain can either be present before, after or during activity depending on severity
  • There may be associated swelling
  • In chronic cases you may feel lumps within the tendon
Causes of Achilles Tendinopathy

Achilles tendinopathy is caused by excess strain on the Achilles tendon. Factors that can increase load and strain on the Achilles tendon include:

  • Poor foot mechanics or excess foot pronation
  • Tight or weak calf muscles
  • Poor ankle joint flexion
  • Increase in training or loads
  • Inadequate warm up or stretching before sport
  • Activities involving running, jumping, hopping or sudden changes of direction
  • Poor footwear

Achilles tendinopathy occurs when there is too much strain on the tendon, resulting in small micro tears within the tendon fibers.

Achilles tendinosis occurs when there is repeated micro trauma or degeneration to the tendon. It results in scar tissue build up within the tendon due to the chronic torn fibers. This can often be felt as a lump within the tendon.

Achilles tendon rupture occurs when there is complete or partial tear. This can be the result of an acute incident such as a sudden pivot, jump or acceleration or degeneration of the tendon. An Achilles tendon rupture results in a sharp onset of pain with significant swelling making weight bearing difficult. Athletes may even hear the tendon snap. Surgery if often required for complete Achilles tendon ruptures.

Treatment for Achilles Tendinopathy
  • Strapping
  • Ultrasound or laser therapy
  • Stretching and strengthening
  • Footwear advice
  • Orthotics

Treatment is firstly aimed at reducing strain on the tendon to reduce symptoms and followed by a focus on progressive exercises to stretch and strengthen the Achilles. Addressing the cause of Achilles tendinopathy is often the key to success and helps prevent a reoccurrence.

Poor foot mechanics and excess foot pronation are often causative factors that get overlooked as this places more strain on the Achilles tendon when the foot rolls in.

Early diagnosis and treatment with a podiatrist can help treat Achilles tendinopathy and prevent it becoming a chronic condition.