What is an Achilles tendinopathy? Achilles tendon Injury

Supine Ankle Assessment

What is an Achilles tendinopathy? Achilles tendon Injury

What are tendons?

Achilles tendon diagramTendons generate forces from the muscles to the bone to create a movement (movement of he body part may or may not occur). The Achilles tendon are commonly sensitive because they absorb forces when we bend our ankle in an up and down motion (dorsiflexion and plantarflexion). The Achilles tendon is like a human spring they absorb tensile forces the release these forces when we move. When forces are applied ‘too fast too quick’ tendinopathies may occur.


What is a tendinopathy?

Tendinopathy generally means abnormal change to tendon biology and increase sensitivity (pain). The symptoms usually increases during or after activity. Tendon symptoms either isolated pain Eg: Patella and Achilles or diffused pain Eg: Hamstring and Gluteal. ‘Stiff, tight, tension’ are commonly described in the morning in the morning or after activity during rest.

What may cause a tendinopathy?

Many Factors may affect how a tendon performs.

Non-modifiable (Keep in mind we can build your capacity)

Age: Cellular repair reduces when we age; this can increase the risk of injury

Genetic: Some genes may increase the risk

Your bony structure: Where the tendon connects to bone can vary; which may increase the risk factor

Modifiable (Changes that you may choose to change or not change)

Loads: ‘too much too quick’. Given activity, sport, running, etc.

Obesity: Increase the load to your limbs which may increase to increase stress for muscles to generate force

Hormones: Women during menopause are more likely to experience tendinopathies due to reduce oestrogen levels.

Muscle weakness: Non-conditioned muscles for a given activity may not be able to support the tendon and may increase the loads to the tendon

Biomechanics: The way you position yourself during an exercise and the stiffness of your joints may increase the loads in the tendon

Supine Ankle Assessment

Does Tendon damage = pain?

Most sensitive tendons have pathology. On the other hand a lot of humans have pathology but no pain (asymptomatic). Similar to Covid19 you may be experiencing the virus but may not show any signs and symptoms. Unfortunately we see structural changes via Ultrasound imaging but cannot tell a human that they will experience symptoms based off a scan. What may influence pain are biochemical, temperature, pressures, and other psychosocial factors (research still developing in this field).

How do we diagnosis Achilles tendon injury?

  • Subjective history on your loads you place your lower limb
  • Any medication that may increase your risk of achilles tendinopathy: Fluoroquinolone antibiotics, such as ciprofloxacin (Cipro)or levofloxacin (Levaquin)
  • Rule out other surrounding conditions: haglunds deformity, retrocalcaneal burisitis, os trigonium, calcaneal fracture etc.
  • Redness and pain on palpation over the insertion or tendon belly
  • Stiffness in the morning in foot/ankle.
  • Sensitivity during/after loads.

Prone ankle assessment

If you are interested in a achilles tendon assessment with one of our allied health professionals, feel free to book online or call our team on 02 9252 2825.

Post by: Podiatrist Richard Ching