Achilles Tendinopathy Overview

A common overuse injury that affects the Achilles tendon, usually caused by repetitive strain and excessive stress.

The thickest and strongest tendon in the body, connecting the calf muscles to the heel bone.

A connective tissue sheath surrounding the Achilles tendon that helps with movement and provides blood supply.

An area of the Achilles tendon with reduced blood supply, making it more susceptible to injury and degeneration.

Repetitive impact loading, like running and jumping, can lead to inflammation and pain in the Achilles tendon or its surrounding tissues.

This term implies an acute inflammatory process within the tendon, which may not always be the case.

A more accurate term for Achilles tendon pain, indicating a variety of pathological changes within the tendon.

A serious injury where the Achilles tendon ruptures or tears, often caused by sudden forceful movement or overload.

Observable swelling and thickening of the Achilles tendon, often with a palpable lump or nodules, and crepitus during ankle movement.

A test where the examiner palpates the Achilles tendon while the patient dorsiflexes and plantarflexes the ankle.

A test where the examiner palpates the Achilles tendon while the patient moves the ankle from dorsiflexion to plantarflexion.

Limited ankle dorsiflexion due to tightness in the calf muscles.

Tightness in the hamstring muscles, often associated with Achilles tendon pathology.

A palpable thickening of the Achilles tendon that does not move with ankle movement, suggesting involvement of the tendon sheath.

A stethoscope can be used to detect crepitus if it cannot be felt.

When the examiner cannot find a swollen area, they palpate a specific point on the tendon during ankle movement.

Occurs when the Achilles tendon is repeatedly stressed beyond its capacity, usually due to insufficient rest and recovery time.

Forceful, sudden movement, especially involving eccentric contraction (muscle lengthening while being stretched), can damage the Achilles tendon.

Tightness in the calf muscles (gastrocnemius and soleus) increases strain on the Achilles tendon, making it more prone to micro tears.

Weak calf muscles (gastrocnemius and soleus) increase strain on the Achilles tendon, leading to small tears and inflammation.

Abnormal foot structure (high arch) leading to poor shock absorption and making the Achilles tendon more susceptible to injury.

Excessive inward rolling of the foot during walking or running, putting stress on the Achilles tendon, especially on its medial side.

Conditions such as diabetes, lupus, and gout can weaken the Achilles tendon, making it susceptible to injury.

A type of Achilles tendinitis where the inflammation affects the area where the tendon attaches to the heel bone.

A type of Achilles tendinitis where the inflammation affects the middle part of the tendon.

A specific imaging test that is usually the first choice in diagnosing Achilles tendinitis as it helps visualize the tendon's structure and any abnormalities.

A treatment approach for Achilles tendinitis that involves various techniques to reduce pain, swelling, and inflammation. This might include RICE (rest, ice, compression, elevation), physical therapy, or medication.

A common symptom of Achilles tendinitis where pain is experienced when the foot is moved upwards in a passive manner.

A common sign of Achilles tendinitis, particularly in chronic cases, where the calf muscle shrinks due to inactivity and lack of use.

A treatment method for Achilles tendinitis involving injections of corticosteroid medication directly into the inflamed area to reduce inflammation and pain.

Switching from high-impact activities like running to low-impact activities like biking or swimming reduces stress on the Achilles tendon during exercise.

Clinicians should advise patients with non-acute Achilles tendinopathy to continue their recreational activities within their pain tolerance while participating in rehabilitation, rather than complete rest.

Exercising the uninjured ankle can stimulate the injured Achilles tendon, preventing muscle atrophy and promoting healing. This phenomenon is called the "crossover effect."

Applying ice to the painful area of the Achilles tendon can reduce inflammation and pain.

Electrotherapy modalities like ultrasound, low-level laser therapy, and iontophoresis with dexamethasone can be used to treat Achilles tendinopathy.

Extracorporeal Shockwave Therapy (ESWT) delivers high-energy shockwaves to stimulate the healing process in the damaged Achilles tendon.

Taping and orthotics can support and protect the inflamed Achilles tendon.

A walking boot can provide short-term rest for a severely painful Achilles tendon, but prolonged use can weaken the calf muscle.

A gentle stretching technique for a shortened gastrocnemius/soleus muscle complex, applied early to stimulate tendon repair.

Exercises focusing on the eccentric (negative) part of movement, improving tendon healing and sports return.

Closed-chain exercises with heavy eccentric loading, such as weighted heel raises, for collagen re-orientation and strength.

A static tendon loading exercise, holding the tendon in a contracted position for a period, to relieve pain and maintain strength.

Progressive exercises involving muscle contractions and releases, like calf raises, introduced when pain and stiffness reduce.

Isotonic exercises performed while seated, aiming to strengthen the calf muscles and tendon.

Isotonic exercises performed standing, focusing on the mid-range of motion to avoid tendon compression.

Advanced exercises that involve the rapid deformation of the tendon through jumping and hopping, restoring energy storage capacity.