Condition spotlight

Achilles Tendonitis

Achilles Tendonitis (tendinopathy) is a broad term referring to a range of conditions describing injury to the Achilles tendon. It is caused by an acute or chronic tendon overload, usually leading to a rapid onset of pain, stiffness and loss of function. This can occur at the heel where the tendon attaches (insertional Achilles tendinopathy), or higher in the tendon on the lower aspect of the calf (midportion Achilles tendinopathy). There are several stages involved in the progression of this condition:

The first two stages are reversible if managed early and correctly. However, once it progresses further, it can be much more challenging to rehabilitate, hence the importance of seeking early treatment.

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achilles tendonitis
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Frequently asked questions about Achilles Tendonitis

Who gets Achilles tendinopathy or Achilles Tendonitis?

Achilles tendinopathy is common in athletes, with observational data suggesting that competitive athletes have a lifetime incidence of Achilles tendinopathy of 24 percent, with 18 percent sustained by athletes younger than 45 years. Amongst competitive runners, the lifetime incidence of Achilles tendinopathy may be as high as 40-50%. However, this condition can affect anyone regardless of physical activity levels, from elite athletes, to weekend warriors, and to those with a more sedentary lifestyle.

Achilles tendinitis and Achilles tendinopathy? What’s the difference?

Achilles tendinopathy is an umbrella term which encompasses all conditions affecting the Achilles. You may have heard of some of these terms being used interchangeably. Most of us are familiar with the term Achilles tendinitis, with ‘itis’ being inflammation. This term is generally referring to the early stage (reactive phase) of tendinopathy, and is perhaps incorrectly used, as the inflammation is not the source of Achilles pain. For this reason, it is more widely accepted to use the term tendinopathy to describe the condition.

Do I need to stop activity and rest?

While it may seem instinctive to rest to protect the tendon from further injury, research suggests complete rest is not all that good for the long term. Too much rest can cause weakening of the tendon, enabling a slower recovery. Relative rest and modified activity may be needed to settle flare ups of the Achilles, followed by an early start to a progressive heavy load strength training program.

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