Understanding Achilles tendinopathy: a comprehensive guide

Achilles tendinopathy is a common condition that affects the Achilles tendon, the largest tendon in the body.

This condition is particularly prevalent among athletes and active individuals, but it can affect anyone.

In this blog post, we will explore the different names for Achilles tendinopathy, who is commonly involved, how the condition is diagnosed, and the various treatment options available.

Our goal is to provide valuable information for those in Frankston seeking physiotherapy and podiatry services at Lifecare Frankston.

Different names for Achilles tendinopathy

Achilles tendinopathy is known by several names, reflecting the evolving understanding of the condition.

Historically, it was often called Achilles tendinitis, implying inflammation.

However, research has shown that the condition is more about degeneration than inflammation, leading to the preferred term ‘tendinopathy’.

Other terms you might encounter include Achilles tendinosis, which specifically refers to the chronic degeneration of the tendon without inflammation.

Who is commonly involved?

Achilles tendinopathy can affect anyone, but it is most common in:

• Athletes: Particularly runners, basketball players, and soccer players who put repetitive stress on their Achilles tendon.
• Middle-aged individuals: As tendons lose elasticity with age, making them more susceptible to injury.
• People with certain risk factors: These include obesity, high blood pressure, and diabetes, which can all contribute to tendon degeneration.

How is Achilles tendinopathy diagnosed?

Diagnosing Achilles tendinopathy typically involves a combination of clinical history and objective evaluation, imaging studies may be requested however do not always correlate with presenting symptoms.

Here’s what you can expect during a visit to Lifecare Frankston:

1. Medical history: Your physiotherapist will ask about your symptoms, activity level, and any previous injuries.
2. Physical examination: This includes palpating the Achilles tendon to check for pain, swelling, or thickening. The physiotherapist may also assess your range of motion, strength and ability to load.
3. Imaging: Ultrasound or MRI may be useful to confirm the diagnosis and assess the extent of tendon degeneration, however, should not be used to diagnose a tendinopathy alone.

Treatment options

Treatment for Achilles tendinopathy aims to reduce pain, promote healing, and restore function.

Here are some common approaches:

Activity modification

Reducing activities that aggravate the tendon is crucial. This might involve switching to low-impact exercises like swimming or cycling, or in some cases, rest.

Physiotherapy

A tailored physiotherapy program at Lifecare Frankston can include:

• Manual therapy: Techniques such as massage and mobilisation can help reduce pain and improve overall function.
• Strengthening and mobility: Specific exercises to improve flexibility and strength in the calf muscles and Achilles tendon. These exercises include:
• Isometric holds: Muscle contractions without changing length to reduce pain and build initial strength.
• Eccentric exercises: Lengthening the tendon under load to promote tendon healing.
• Isotonic exercises: Muscle contractions with length changes, such as calf raises, progressing from both legs to single-leg.
• Plyometric exercises: Jumping and hopping to prepare the tendon for high-impact activities.

Gradual return to sport

A structured plan to gradually reintroduce sporting activities, ensuring the tendon is adequately prepared for the demands of the sport.

Podiatry

Podiatrists at Lifecare Frankston provide comprehensive care that includes:

• Biomechanical assessment: Evaluating the way you walk or run to identify any abnormalities that may contribute to tendon stress.
• Custom orthotics: Providing custom orthotic devices to help correct biomechanical issues. These devices can provide support, reduce strain on the Achilles tendon, and improve overall foot function.
• Footwear advice: Recommending appropriate footwear that offers adequate support and cushioning to reduce stress on the Achilles tendon.
• Gait retraining: Teaching you how to modify your walking or running technique to reduce tendon strain and prevent further injury.

Surgery

Reserved for severe cases that do not respond to conservative treatments, surgery can involve removing damaged tendon tissue or repairing tears.

Achilles tendinopathy is a common and manageable condition.

With the right approach, including physiotherapy and podiatry services at Lifecare Frankston, individuals can recover and return to their normal activities.

If you are experiencing Achilles tendon pain, do not hesitate to seek professional help.

Early intervention can make a significant difference in your recovery journey.

For more information or to book an appointment, contact Lifecare Frankston today.

Our team of experienced physiotherapists and podiatrists is here to help you get back on your feet.

Jasper is a physiotherapist at Lifecare Frankston, with a deep understanding of musculoskeletal conditions, including Achilles tendinopathy. His expertise in manual therapy, exercise prescription, and patient education ensures that those suffering from Achilles tendinopathy receive comprehensive care to promote healing and restore function.

References

• Libby, J., Callahan, E. A., Li, J., & Iafrate, J. L. (2024). Evidence-Based Management of Achilles Tendinopathy in the Athletic Population. Current Physical Medicine and Rehabilitation Reports, 12, 266–275.
• Sussmilch-Leitch, S., Collins, N. J., Bialocerkowski, A. E., Warden, S. J., & Crossley, K. M. (2012). Physical therapies for Achilles tendinopathy: systematic review and meta-analysis. Journal of Foot and Ankle Research, 5, Article number: 15.
• Van der Vlist, A. C., Winters, M., Weir, A., Ardern, C. L., Welton, N. J., Caldwell, D. M., Verhaar, J. A. N., & De Vos, R.-J. (2019). Which treatment is most effective for patients with Achilles tendinopathy? A living systematic review with network meta-analysis of 29 randomised controlled trials. British Journal of Sports Medicine, 55(5), 249-258.
• Alfredson, H., & Cook, J. L. (2007). A treatment algorithm for managing Achilles tendinopathy: new treatment options. British Journal of Sports Medicine, 41(4), 208-213.
• Silbernagel, K. G., Thomeé, P., Eriksson, B. I., Karlsson, J., & Hägglund, M. (2011). Eccentric overload training for patients with chronic Achilles tendinopathy: a randomised controlled trial with 12-month follow-up. British Journal of Sports Medicine, 45(9), 715-722.