Achilles Tendinopathy

Achilles tendinopathy is a condition that causes pain, swelling and stiffness of the Achilles tendon. It is thought to be caused by repeated tiny injuries (known as microtrauma) to the Achilles tendon. After each injury, the tendon does not heal completely, as should normally happen. This means that over time, damage to the Achilles tendon builds up and Achilles tendinopathy can develop.

Risk Factors 

A number of factors may increase your risk of Achilles tendinitis, including:

  • Your sex. Achilles tendinitis occurs most commonly in men.

  • Age. Achilles tendinitis is more common as you age.

  • Physical problems. A naturally flat arch in your foot can put more strain on the Achilles tendon. Obesity and tight calf muscles also can increase tendon strain.

  • Training choices. Running in worn-out shoes can increase your risk of Achilles tendinitis. Tendon pain occurs more frequently in cold weather than in warm weather, and running on hilly terrain also can predispose you to Achilles injury.

  • Medical conditions. People who have psoriasis or high blood pressure are at higher risk of developing Achilles tendinitis.

  • Medications. Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.

What are the Symptoms 

The main symptoms include pain and stiffness in the affected Achilles tendon. Pain and stiffness tend to develop gradually and are usually worse when you first wake up in the morning. (Severe pain that comes on suddenly and difficulty walking can be symptoms of Achilles tendon tear (rupture). See a doctor urgently if you develop these symptoms.)

Treatment Options 

Activity Modification 

Rest and time off from sporting activities are important if you have Achilles tendinopathy. At first, you should stop any high-impact activities or sports (such as running). As pain improves, you can restart exercise as your pain allows. 

Targeted Exercises 

Some special exercises to help to stretch and strengthen your Achilles tendon have been proven to be helpful. You should aim to do these every day. Such exercises may help with pain control and stiffness. 

Orthotics may recommend if there is an abnormality in alignment or function of the Achilles tendon as this may be resulting in damaging forces within the tendon. Changing your footwear or putting special inserts in your shoes, such as inserts to lift your heel. This may help to reduce pain and symptoms.

Shockwave therapy involves the delivery of high-intensity ultrasound waves through a special handpiece which stimulates the release of growth factors and increases blood supply to the area to facilitate healing. It also decreases the neuroinflammatory processes targeting the cause of pain in Achilles tendinopathy. 

Also called proliferation therapy, regenerative injection therapy or proliferative injection therapy. This procedure involves injecting an otherwise non-drug irritant solution into the body to repair regions and to alleviate pain.

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