Achilles tendinopathy

Achilles tendinopathy is a term used to describe an intra-tendinous disorder caused by overuse injury of the Achilles tendon. It was previously known as Achilles tendinitis or tendinosis but these terms are no longer normally used.

• continued overload of the tendon results in a failed healing response, which may result in degenerative changes in the tendon (1)

Two categories of the condition can be described according to the anatomical location:

• insertional tendinopathy - at the calcaneus-Achilles tendon junction
• non-insertional tendinopathy - 2 to 6 cm proximal to the insertion of the Achilles tendon into the calcaneus (1)

It is most commonly seen in people who participate in the physical activities such as running and jumping.

• it has an annual incidence of 2.35 per 1,000 adults registered with a GP (3)
• it may affect 9% of recreational runners and cause up to 5% of professional athletes to end their careers
• an epidemiological study of 1394 nonathletes reported the condition in 5.6% of the subjects (4% insertional, 3.6% non-insertional, and 1.9% both forms)
• insertional tendinopathy tends to occur in more active persons, while older, less active, and overweight persons tends to suffer from non-insertional tendon injury (1)

Reference:

1. Silbernagel KG, Hanlon S, Sprague A; Current Clinical Concepts: Conservative Management of Achilles Tendinopathy. J Athl Train. 2020 May;55(5):438-447
2. Li HY, Hua YH.Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments. Biomed Res Int. 2016;2016:6492597.
3. de Jonge S, van den Berg C, de Vos RJ, et al; Incidence of midportion Achilles tendinopathy in the general population. Br J Sports Med. 2011 Oct;45(13):1026-8.