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Achilles Tendonitis and Tendinitis

Achilles Tendonitis and Tendinitis

Achilles Tendonitis is a term that commonly refers to an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that requires the same repetitive action.

Most experts now use the term Achilles tendinopathy to include both inflammation and micro-tears. But many doctors may still use the term tendonitis out of habit.

What Causes Tendon Pain?

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but usually it is the result of many tiny tears to the tendon that have happened over time.

Health professionals may use different terms to describe a tendon injury. You may hear:

Tendonitis (or Tendinitis): This actually means "inflammation of the tendon" but inflammation is rarely the cause of your tendon pain.

Tendinosis: This refers to tiny tears in the tissue in and around the tendon caused by overuse.

What Causes Achilles Tendonitis?

Achilles tendonitis is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that require the same repetitive action.

Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or ageing. Anyone can have a tendon injury, but people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon.

A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time.

Common Causes of Achilles Tendonitis include:
  • Over-training or unaccustomed "use too much too soon"
  • A sudden change in training surface e.g. grass to bitumen
  • Flat (overpronated) feet
  • High foot arch with tight Achilles tendon
  • Tight hamstring (back of thigh) and calf muscles
  • Toe walking (or constantly wearing high heels)
  • Poorly supportive footwear
  • Hill running.
  • Poor eccentric strength
What are the Symptoms of Achilles Tendonitis?

Achilles tendonitis may be felt as a burning pain at the beginning of an activity, which gets less during activity and then worsens following activity. The tendon may feel stiffness first thing in the morning or at the beginning of some exercise.
  • Achilles tendonitis usually causes pain, stiffness, and loss of strength in the affected area.
  • The pain may get worse when you use your Achilles tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.
How is Achilles Tendonitis Diagnosed?

Your physiotherapist or sports doctor can usually confirm the diagnosis of Achilles tendonitis in the clinic. They will base their diagnosis on your history, symptom behaviour and clinical tests.

Achilles tendons will often have a painful and prominent lump within the tendon.