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Tendo Achilles Disorders

Updated by Matt Costa, 2005

Achilles Tendinopathy     [Back To Top] 

Achilles tendinopathy represents a common and debilitating spectrum of conditions. These range from acute Achilles tendon pain, to chronic painful Achilles tendinosis, to rupture of the tendon. Symptoms from the Achilles tendon result in prolonged periods of absence from work and sporting activity. The incidence of rupture is increasing in the Western World.  Despite this fact, there are large areas of Achilles tendon pathology that are poorly understood and most therapeutic interventions are controversial.

Nomenclature     [Back To Top] 

  • The term ‘tendinitis’ should be reserved for acute Achilles tendon pain, usually as a result of trauma. This may have an inflammatory component. It is usually self-limiting and responds to analgesia and modified activity.
  • 'Tendinosis’ is the term used for chronic degenerative change within the tendon. There does not appear to be a major inflammatory component to these changes.  The condition is common and often asymptomatic. Those patients who have pain are often resistant to treatment.
  • ‘Tendinopathy’ is probably the safest term for all tendon pathology as it does not imply an aetiology

Aetiology    [Back To Top]   

In the normal tendon the collagen fibres are arranged in a linear fashion with a characteristic crimp. The tenocytes are ‘squashed’ into oval shapes between the fibres.

In tendinosis the fibre alignment and structure becomes less well defined and eventually is lost. The tenocytes become more round. The number of tenocytes may decrease (or in cases of painful tendinopathy increase.)

Fig 1. Normal tendon and tendinosis

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