Achilles Tendinopathy

Common causes include:

• Overuse: Repetitive and intense activities, such as running and jumping, can cause continuous stress on the tendon and lead to tendinopathy development.
• Biomechanical alterations: Misalignments or inadequate movement patterns can overload the tendon and contribute to pathology development.
• Inadequate footwear: Using footwear that doesn't offer proper support can increase risk of tendinopathy, especially during physical activities (such as running).
• Insufficient warm-up: Lack of proper warm-up and stretching before physical activities can increase risk of tendon injury.

Typical symptoms include:

• Localized pain: Pain in the back of the ankle, which can start mild and increase over time, especially after physical activities.
• Stiffness: Sensation of stiffness in the tendon region, especially in the morning or after periods of inactivity.
• Swelling: Mild swelling in the tendon area, which may not be visible but can be palpable to touch.
• Tenderness: Sensation of tenderness or discomfort when pressing the tendon area.

To diagnose this problem, doctors use:

• Physical examination: Assessment of pain, tenderness, range of motion, and examination of tendon area to identify signs of inflammation or degeneration.
• Imaging Tests: Ultrasound or magnetic resonance imaging (MRI) can be used to visualize tendinopathy extent and check for tendon degeneration or other associated injuries.

Treatment can vary according to tendinopathy severity and response to initial treatment:

• Conservative: Includes rest, ice application, use of non-steroidal anti-inflammatory drugs (NSAIDs) to control pain and inflammation, physical therapy to strengthen muscles around the ankle and improve tendon flexibility. Specific stretching and strengthening exercises, such as eccentric exercises, are often recommended.
• Activity modification: Reducing or modifying activities that cause tendon stress can help recovery. Low-impact alternatives, such as swimming or cycling, may be suggested.
• Additional treatments: In persistent cases, additional therapies such as shock wave therapy or injections may be considered. In severe cases, surgery may be necessary.

Some preventive measures include:

• Strengthening and stretching: Perform regular exercises to strengthen muscles of the gastrocnemius-soleus-calcaneal-plantar system and stretching of this complex.
• Proper warm-up: Always warm up and stretch before intense physical activities.
• Appropriate footwear: Use appropriate footwear that offers proper support and cushioning to reduce impact on the tendon.
• Technique correction: Adjust running techniques or other physical activities to minimize tendon stress.