Achilles Tendinopathy

Achilles tendinopathy is a condition that affects the Achilles tendon, which connects the calf muscles to the heel bone. It is characterized by pain, stiffness, and swelling in the tendon, typically resulting from overuse or repetitive stress. The condition can be divided into two types:

Insertional Achilles tendinopathy

This occurs at the point where the tendon attaches to the heel bone.

Non-insertional (mid-portion) Achilles tendinopathy

This affects the middle part of the tendon, a few centimeters above the heel.

Causes

– Overuse or repetitive strain: Common in runners, athletes, or people engaging in activities that involve repetitive stress on the tendon.
– Poor footwear: Wearing shoes that do not provide adequate support during exercise or walking.

– Biomechanical factors: Flat feet, high arches, or abnormal walking/running mechanics can contribute.
– Sudden increase in activity: A sudden boost in intensity or frequency of physical activity.
– Aging: The tendon becomes less flexible with age, increasing the risk of injury.

Symptoms

– Pain and stiffness in the tendon, particularly in the morning or after rest.
– Swelling along the tendon.
– Tenderness when touched.

– A grating or crackling sound when moving the ankle.
– Reduced range of motion in the ankle.

Treatment

– Rest and activity modification: Reducing activities that aggravate the condition.
– Ice application: To reduce swelling and pain.
– Physical therapy: Eccentric exercises (lengthening of the tendon under tension) can be particularly helpful in treating tendinopathy.
– Orthotics or footwear changes: Supportive shoes or inserts may reduce stress on the Achilles tendon.

– Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) may help with pain and swelling, but they don’t treat the underlying tendon damage.
– Shockwave therapy: This non-invasive treatment can stimulate tendon healing in chronic cases.
– Surgery: In severe or persistent cases, surgical intervention may be required to remove damaged tissue.

Prevention

– Gradual increase in activity levels to avoid sudden overload.
– Proper warm-up and stretching before physical activities.

– Wearing supportive footwear that suits your activity and foot structure.
– Strengthening and conditioning exercises, especially for the calf muscles.

If untreated, Achilles tendinopathy can progress and increase the risk of tendon rupture, which is a more serious injury requiring surgical repair.

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