Achilles Tendinopathy

Achilles tendinopathy is a common condition that results from degeneration of the Achilles tendon. The term Achilles tendinopathy means pathology within the tendon and has replaced the term tendinitis as research has found the condition to involve degeneration of the tendon, rather than an inflammatory response.  A tendons role is to transmit force from the muscle to bone as well as absorb any external forces from over straining the muscle. To achieve this, a tendon must have adequate strength, flexibility and elasticity as well as adequate recovery time. Achilles tendinopathy usually results from repetitive or prolonged activities such as excessive walking, running etc that overloads the capabilities of the tendon. Beginning an aggressive training program after being sedentary for a period is also seen as an aggravating factor for Achilles tendinopathy. As a result of aggravating factors, the tendon substance changes causing a reduction in tensile strength of the tendon.  Inflammation of the paratendon (sheath around the tendon) is occasionally seen.

Signs and symptoms of Achilles tendinopathy include pain at the beginning and end of exercise with pain easing once warmed up. Stiffness first thing in the morning and after being seated for a period of time is also common. As the condition worsens, pain will be felt earlier into exercise or will not ease after warming up.

Management of Achilles tendinopathy includes addressing all of the contributing factors which could be calf tightness, overpronation of the foot, inappropriate footwear, poor technique, muscle weakness and many more.  Since tendon repair and remodelling is stimulated by load, complete rest can be detrimental to Achilles tendinopathy. A period of ‘modified rest’ (Ie: rest from aggravating and painful activities) while completing a gradual strengthening program under the advice of your physio, is an important part of successful rehabilitation.


By Jessica Norton

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