(Achilles Tendonitis; Achilles Tendonosis)
DefinitionTendons connect muscle to bone and often connect near a joint. Tendonopathy is an injury to the tendon. It can cause pain and swelling and makes it difficult to move. Tendonopathy may be:
- Tendonitis—inflammation of the tendon
- Tendonosis—tiny tears in the tendon with no major inflammation
|Copyright © Nucleus Medical Media, Inc.|
CausesTendinopathy is generally caused by overuse of a muscle-tendon unit. Over time, the strain on the tendon causes structural changes within the tendon.Overuse of the Achilles tendon can occur with activities such as:
- Increasing your speed or running long distances too quickly
- Suddenly adding strenuous hills or stair climbing to your exercise routine
- Doing too much too soon after taking time away from exercising
- A sudden or violent contraction of the calf muscles, such as during an all-out sprint
- Running too much
- Lack of flexibility of the calf muscles
Risk FactorsAchilles tendonopathy is more common in older adults due to the aging process. Factors that may increase your risk of getting Achilles tendonopathy include:
- Improper or badly worn footwear
- Inflexibility of the calf muscles
- An improper training program—such as increasing intensity too quickly
SymptomsSymptoms of tendonopathy may include:
- Tenderness—usually just above the heel bone and often more noticeable in the morning
- Stiffness that gradually eases as the tendon is warmed-up
- Pain after activity that gradually worsens
- Pain along the tendon during and/or after running
- Swelling in the area of the Achilles tendon
- Pain at the back of the ankle
DiagnosisYou will be asked about your symptoms and exercise habits. A physical exam will be done. A diagnosis will be made based on the exam and history.Images of the bones and tendons may be taken. This can be done with:
TreatmentTendinopathy and the associated pain may take months to resolve. It can be frustrating, but it is important to follow through with the advised treatment.
Supportive CareThe tendon will need time to heal. Treatment may include:
- Restricting activities
- Ice therapy to help relieve swelling
- A shoe insert that places the foot in the correct position
- Ankle taping to support the area
Physical TherapyA physical therapist will assess the tendon. Ultrasound and/or massage may be done to help relieve tension. An exercise program will be created to help recovery and to strengthen the calf muscles.
PreventionTo decrease your chances of getting Achilles tendonitis:
- Wear appropriate footwear for your sport.
- Do not use shoes beyond the advised duration. This will depend on:
- How frequently you exercise
- The surface on which you exercise
- The conditions in which you exercise
- Gradually add hill work, stairs, speed, and distance to your routine.
- Stretch and strengthen the calf muscles regularly.
American College of Sports Medicine
OrthoInfo—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Achilles tendinopathy. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated April 29, 2014. Accessed March 2, 2015.
Achilles tendinitis. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00147. Updated June 2010. Accessed March 2, 2015.
Common disorders of the achilles tendon. American College of Foot and Ankle Surgeons Foot Health Facts website. Available at: http://www.foothealthfacts.org/footankleinfo/achilles-tendon.htm. Accessed March 2, 2015.
de Jonge S, van den Berg C, de Vos RJ, et al. Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med. 2011;45(13):1026-1028.
Irwin TA. Current concepts review: insertional achilles tendinopathy. FootAnkle Int. 2010;31(10):933-939.
10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
- Reviewer: Teresa Briedwell, PT, DPT
- Review Date: 03/2015
- Update Date: 02/28/2014
Many medical groups felt that early exposure to certain foods like peanuts increased a child's risk of developing food allergies. However, newer research including this trial suggest that early exposure may actually decrease the risk of developing food allergies.
Breastfeeding May Decrease the Risk of Childhood Obesity
Tonsillectomy May Reduce Number of Sore Throat Days in Children
Research Review Finds Little Support for Nearly Half of Medical Talk Show Recommendations