Tendons connect muscle to bone and often connect near a joint. Tendinopathy is an injury to the tendon. It can cause pain and swelling and makes it difficult to move. Tendinopathy may be:

• Tendinitis—inflammation of the tendon
• Tendinosis—tiny tears in the tendon with no significant inflammation

The Achilles tendon connects the calf muscle to the heel bone. Achilles tendinopathy is pain in this tendon.

• Increasing speed or running long distances too quickly
• Suddenly adding strenuous hills or stair climbing to an 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

• Improper or badly-worn footwear
• Inflexibility of the calf muscles
• An improper training program—such as increasing intensity too quickly
• Increased age—normal wear and tear can make the tendon more likely to become injured

• 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 that gradually worsens after activity
• Pain along the tendon during and/or after running
• Swelling in the area of the Achilles tendon
• Pain at the back of the ankle

• X-rays
• Ultrasound
• MRI scan

• Stretching
• Massage
• Ultrasound
• Custom orthotics
• Strengthening exercises that focus on the calf muscles
• Balance activities

• 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.

• American College of Sports Medicine

http://acsm.org

• OrthoInfo.org - American Academy of Orthopaedic Surgeons

http://orthoinfo.org

• Canadian Orthopaedic Association

http://www.coa-aco.org

• Canadian Orthopaedic Foundation

http://www.canorth.org

• Achilles tendinopathy. EBSCO DynaMed website. Available at:  http://www.ebscohost.com/dynamed Updated July 9, 2013. Accessed February 28, 2014.
• Achilles tendinitis. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:  http://orthoinfo.aaos.org/topic.cfm?topic=A00147 Updated June 2010. Accessed February 28, 2014.
• 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 February 28, 2014.
• 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. Foot Ankle 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.