Achilles tendinopathy

Abstract

Achilles tendinopathy is a common clinical condition. The aetiology of Achilles tendinopathy remains unclear, but is probably multifactorial resulting from a combination of intrinsic and extrinsic factors. Excessive loading of the tendon during vigorous training activities is regarded as the main pathological stimulus. The Achilles tendon may respond to repetitive overload beyond physiological threshold by either inflammation of its sheath, degeneration of its body, or a combination of both. Conservative management, including relative rest, anti-inflammatory drugs, physiotherapy and orthoses may be beneficial. Surgery is generally recommended after exhausting conservative management, usually after at least three to six months. Long-standing Achilles tendinopathy is associated with poor postoperative results, with a greater rate of reoperation before reaching an acceptable outcome.