Achilles “Tendinitis”. Is it really an “itis”?

The Achilles tendon is the most commonly injured tendon in the human body with an incident rate of 2.5 per 1000 adults. Injury to the tendon can range from a “tendinitis” or tendinopathy to a complete rupture. “Tendinitis” ┬áis typically caused by repetitive overload and training errors such as rapidly increasing training intensity or duration. These training errors are reported to be contributing factors in 60-80% of those who develop this condition.AchillesSmaller

Recent research has shown that inflammation (“tendinitis”) is not the predominant feature in the overused injured Achilles or other commonly injured tendons of the body. Microscopic studies show a poor healing response, collagen degeneration, and disorientation of the tendon fibers. This is why there has been a shift in terminology from “tendinitis” to “tendinopathy”. There are 2 types of Achilles tendinopathy and it is determined by the source of the pain; midportion (identified by pain 2-6 cm above the level of the Achilles tendon insertion into the heel bone), and insertional (at the insertion of the Achilles tendon into the heel bone). Other than location of pain, symptoms are similar in both types of tendinopathy. Common symptoms include pain during activity, morning stiffness, and tenderness and tendon thickening along the specific point of the affected tendon.

Options for treatment include exercise, foot orthotics, ultrasound, electrical stimulation, injections, laser, shockwave therapy, and surgery. Based on the current research, exercise is the most effective way to manage Achilles tendinopathy. Suggested guidelines recommend a minimum of 3 months of exercise as the primary type of rehab before initiating the interventions such as those listed above.

At Sports and Spine Rehab, we offer a comprehensive program for those with Achilles tendon problems. This includes manual therapy, exercise, and a return to running program. We can also make recommendations with shoe wear and proper foot striking pattern. Call us today and let us get you back in the game