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.
Tendinopathy is generally caused by overuse of a muscle-tendon unit. Over time, the strain on the tendon causes internal structural change.
Overuse of the Achilles tendon can occur with activities such as:
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
Factors that may increase the risk of having Achilles tendinopathy include:
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
Symptoms of tendinopathy 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 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
The physician will ask about symptoms and exercise habits. A physical exam will be done and a diagnosis will be made based on the exam and history.
Images of the bones and tendons may be taken with:
Physical therapy intervention is an important part of treatment for Achilles Tendinitis. Tendinopathy and the associated pain may take months to resolve. It can be frustrating, but it is important to follow through with the advised treatment.
Rest and ice are the first steps. It’s important to take a break from any activity that causes pain. A physical therapist will practice the RICE principles: Rest, Ice, Compression and Elevation, as well as give activities that do not put stress on the tendon.
Depending upon the severity of the injury, physical therapy may also include:
Strengthening exercises that focus on the calf muscles
To decrease the chances of having Achilles tendinitis:
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.
This content was created using EBSCO's Health Library
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.