ACHILLES TENDINOPATHY

Mattison Barone
What is the Achilles tendon?
The Achilles tendon is located behind the heels of your feet.
The tendon connects your heel bone to the muscles in your calf.
What is Achilles Tendinopathy?
The overuse of the Achilles tendon causes the tendon to
become thickened and uneven. After it is injured, it does not have
time to heal. Over time, all these small injuries lead up to a big one
also known as Achilles tendinopathy.
Types?
Insertional: Damage is where the Achilles tendon joins to the heel bone on the junction.
Non-insertional: Damage is 2-6cm from the part of the tendon that inserts to the heel
bone.
Three Different Stages of Achilles Tendinopathy
Reactive Tendinopathy: The early stages of tendinopathy and is reversible.
Tendon Disrepair: Tendon structure begins to change
Degenerative Tendinopathy: more common in older athletes; tendon becomes less
efficient at doing its job and in this stage, the
tendon will have a risk of rupturing.
Symptoms?
Pain
Swelling
Lack of ability to move Achilles tendon
Risk Factors?
Intrinsic factors are things that you as a
patient cannot control
Some things that cause people to get Achilles tendinopathy are uneven leg length,
leg abnormalities, increasing age, corticosteroid use (medication to treat swelling), diabetes,
gout, obesity, hyperostotic conditions (excessive bone growth), hypertension (high blood
pressure), arthropathies (joint inflammation), aromatase inhibitors (common drug used to treat
breast cancer), and quinolone antibiotics.
 Extrinsic factors are things you as a patient can control
Some things that people do that increases their chance of getting Achilles
tendinopathy are excessive hill training, poor shock absorption, increased mileage, increased
interval training, training on hard or sloping surfaces, and uneven wear (one part of your foot is
being used more due to training on an uneven surface).

Treatment Options?
Immobilization: The use of a boot or a brace to
keep the tendon from being used so it has time to heal.
Orthotics: A heel raise insert for shoes will help
alleviate the pressure on the tendon.
Ultrasound: Stimulates cell division for the
healing of the tendon to reduce swelling.
NSAIDs (Non-steroidal anti-inflammatory
drugs): Things like ibuprofen and aspirin help with the
pain and stiffness in the early stages of Achilles
tendinopathy.
Corticosteroid Injections: Essentially an
anesthetic injected into the Achilles area to help reduce
swelling and pain.
Eccentric Exercises: Certain stretches, such as the ones pictured above, help strengthen
the leg muscles to help with pain and help the tendon heal faster.
Platelet-rich Plasma: Injections of the liquid part of the blood which has growth factors
and other good things to help the Achilles tendon heal faster.
Deep Friction Massage: A deep massage of the affected area helps restore tissue
stretchiness and reduces the strain in the leg muscles.
Aprotinin: is an injection that slows down the thickening of the tendon.
Surgical treatments
Surgery is the last resort treatment after you have tried other treatments listed above for at least
4-6 months.
Non-insertional Surgery: Cut out the degenerative tissue and stimulate tendon healing by
causing controlled trauma.
Insertional Surgery: Removal of the degenerative tendon and a tendon transfer/graft
(taking some of another tendon and putting it where the damaged one was).