Achilles Tendinopathy

What Is Achilles Tendinopathy?

Achilles tendinopathy is a condition involving pain, swelling, and impaired function of the Achilles tendon. It's common in runners and middle-aged "weekend warriors." The term "tendinopathy" is preferred over "tendinitis" as the condition often involves degeneration rather than inflammation.¹

Types

Midportion - Most common (2-6 cm above heel)
Insertional - At heel bone attachment

Symptoms²

Pain and stiffness along tendon
Morning stiffness
Pain with activity (esp. starting exercise)
Swelling or thickening
Tenderness to touch

Risk Factors

Sudden increase in activity
Tight calf muscles
Flat feet or overpronation
Running hills
Improper footwear
Fluoroquinolone antibiotics
Age, obesity, diabetes

Treatment³

Conservative (Most Cases)

Relative rest, activity modification
Eccentric strengthening exercises
Calf stretching
Ice after activity
Heel lifts
Proper footwear

Additional Options

Physical therapy
Shockwave therapy
PRP injections
Night splints

Surgery

Reserved for refractory cases
Debridement or repair

References

Maffulli N, Khan KM, Puddu G. Overuse tendon conditions: time to change a confusing terminology. Arthroscopy. 1998;14(8):840-843.
Kvist M. Achilles tendon injuries in athletes. Sports Med. 1994;18(3):173-201.
Alfredson H, Cook J. A treatment algorithm for managing Achilles tendinopathy. Br J Sports Med. 2007;41(4):211-216.