Achilles Tendinopathy

This generally results from excessive repetitive overload of the tendon to a degree that exceeds its capacity to recover. The preferred term '¡endinopathy' includes a number of conditions which may only be differentiated by direct inspection and histological examination of the tendon or surrounding structures. These include tendinitis, where there is a clear inflammatory process involving the tendon; tendinosis, where there is collagen degeneration within the tendon; and paratendinitis, when there are inflammatory changes in the sheath of the tendon.

The condition is common in athletes, particularly runners and jumpers, but also in footballers, tennis players and ballet dancers. It gives rise to localized pain which is related to lower limb activity. In severe cases of tendinopathy there may be progressive weakness of plantarflexion. accompanied by impaired function and. in some cases, spontaneous rupture of the tendon.

Most cases are treated conservatively by restricting activities, supplemented when required by physiotherapy in the form of tendon stretching exercises, tendon massage, orthotic devices for the shoes, and therapeutic ultrasound. In some resistant case surgical measures such as the removal of fibrotic nodules from within the tendon and the release of tendon adhesions may be required.



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