Achilles Tendinopathy

Achilles Tendinopathy

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What is Achilles Tendinopathy?

Achilles tendinopathy is a common overuse injury that affects the Achilles tendon, often due to repetitive stress and strain. While it's frequently seen in athletes, non-athletes can also suffer from it. This condition can result in pain, stiffness, and sometimes even tears in the tendon, making movement difficult and affecting overall well-being.

Achilles Tendinopathy Statistics

  • Achilles tendinopathy accounts for 55-65% of all Achilles tendon injuries.
  • It is especially prevalent among athletes, with about 7-9% of runners experiencing this condition annually.
  • About 30% of individuals with Achilles tendinopathy may experience long-term symptoms lasting over 1 year.
    • Source: British Journal of Sports Medicine (BJSM)

    Achilles Tendinopathy Anatomy

  • Achilles Tendon: Connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).
  • Tendon Structure: Composed of strong, fibrous collagen fibers that provide flexibility and strength.
  • Blood Supply: Limited blood supply, contributing to slower healing and vulnerability to overuse injuries.
  • Common Site: Occurs primarily in the mid-portion of the tendon, 2-6 cm above the heel bone.

    • Achilles Tendinopathy
    Signs & Symptoms

  • Heel Pain: Gradual onset of pain at the back of the heel, especially during or after activity.
  • Stiffness: Morning stiffness or stiffness after periods of inactivity, particularly in the Achilles tendon.
  • Tenderness: Tenderness and swelling around the Achilles tendon.
  • Reduced Flexibility: Decreased range of motion in the ankle, especially when stretching the calf.

    • Causes of Achilles Tendinopathy

  • Overuse: Repetitive stress from activities like running or jumping.
  • Poor Foot Mechanics: Flat feet or high arches can contribute to increased tendon strain.
  • Inadequate Footwear: Wearing shoes without proper support can exacerbate the condition.
  • Aging: Tendons lose elasticity and strength over time.

    • Risk Factors for Achilles Tendinopathy

  • Overuse: Repetitive stress from activities like running or jumping.
  • Poor Foot Mechanics: Flat feet or high arches can contribute to increased tendon strain.
  • Inadequate Footwear: Wearing shoes without proper support can exacerbate the condition.
  • Aging: Tendons lose elasticity and strength over time.

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    Prevalence of Achilles Tendinopathy

  • Achilles tendinopathy accounts for 55-65% of all Achilles tendon injuries.
  • About 7-9% of runners experience Achilles tendinopathy annually, making it a common overuse injury in athletes.
  • This condition can affect non-athletes as well, particularly those with poor foot mechanics or improper footwear.

    • Assessment & Diagnosis of Achilles Tendinopathy

  • Physical Examination: Tenderness, swelling, and stiffness in the Achilles tendon, especially during palpation or stretching.
  • Patient History: Reviewing the patient’s activity level, footwear, and previous injuries to identify contributing factors.
  • Ultrasound: Used to visualize tendon thickening, neovascularization, and other signs of tendinopathy.
  • MRI Scan: May be employed in chronic cases to assess the extent of tendon degeneration and rule out partial tears.

    • Rehabilitation & Physiotherapy for Achilles Tendinopathy

  • Strengthening Exercises: Focused on the calf muscles and Achilles tendon to restore strength and flexibility.
  • Eccentric Loading: Exercises that involve lengthening the tendon under tension to promote healing.
  • Manual Therapy: Techniques such as deep tissue massage to reduce pain and improve tendon function.
  • Activity Modification: Adjusting activities to reduce strain on the tendon while allowing for recovery.

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    Achilles Tendinopathy FAQs

    Achilles tendinopathy is caused by repetitive stress on the Achilles tendon, often from activities like running or jumping. Contributing factors include poor foot mechanics, inadequate footwear, and aging, which reduces tendon elasticity.

    Achilles tendinopathy is treated through a combination of rest, ice, and physiotherapy exercises aimed at strengthening the tendon. Eccentric loading exercises are particularly effective, and in some cases, shockwave therapy may be used.

    Recovery from Achilles tendinopathy varies but typically takes several weeks to months. Consistent physiotherapy and gradual return to activity are crucial for effective healing and to prevent recurrence.

    Achilles Tendinopathy References

    • Alfredson, H., et al. "Heavy-Load Eccentric Calf Muscle Training for the Treatment of Chronic Achilles Tendinosis." The American Journal of Sports Medicine, vol. 26, no. 3, 1998, pp. 360-366.
    • Maffulli, N., & Khan, K. M. "Overuse Tendinopathy: A Review." Journal of Sports Medicine and Physical Fitness, vol. 43, no. 4, 2003, pp. 338-342.
    • Longo, U. G., et al. "Achilles Tendinopathy." Sports Medicine and Arthroscopy Review, vol. 17, no. 2, 2009, pp. 112-126.

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