Achilles Tendonitis and Exercises

With the increasing number of individuals engaging in recreational and sporting activities, Achilles tendonitis has become one of the fastest rising musculoskeletal conditions, especially with those involved in running activities.

One of the most important discoveries is that the signs and symptoms of Achilles tendonitis are not exclusively caused by prostaglandins, the hormone-like substances that induce inflammation (Gottschlich et al, 2009). Interestingly, a landmark study found that its manifestations are mainly caused by degenerative changes in the Achilles tendon (Astrom & Rausing, 1995). Now that it is no longer strictly recognized as an inflammatory condition, the term Achilles tendonitis is replaced with Achilles tendinopathy or Achilles Tendonosis.

Today, experts and practitioners continuously explore and discover new information about Achilles tendinopathy to implement interventions that may effectively inhibit and alleviate its symptoms, which can be debilitating if left untreated. Simple exercises are effective preventive and protective interventions against this musculoskeletal condition. This will be further discussed in the Exercise section.


The Basics of Achilles Tendonitis

Achilles tendonitis was the term used to describe a spectrum of Achilles tendon injuries, ranging from signs of inflammation and tendon rupture to bone spur formation in the heel and swelling of the fluid-filled sac found at the back of the heel bone.

In 1995, a study published in Clinical Orthopaedics & Related Research indicated that degenerative changes, characterized by abnormal structure of tendon fibers, abnormal excess of cells and proliferation of blood vessels, were noted in 90% of biopsy specimens from symptomatic parts of the Achilles tendons of individuals with chronic Achilles tendonitis (Astron & Rausing, 1995).

Based on these findings, the pathology involving the Achilles tendon is grouped into three classifications: paratenonitis, tendinosis and paratenonitis with tendinosis.

Paratenonitis – It involves inflammation of the surrounding outer layer of the Achilles tendon, the paratenon, which nourishes the tendon. Partial or full tendon ruptures are usually the outcomes of end-stage paratenonitis.

Tendinosis – This degenerative condition of the Achilles tendon is usually caused by repetitive microtrauma or failed inappropriate healing response. When examined, the affected tendon does not demonstrate the presence of inflammatory cells.

Paratenonitis with tendinosis – This condition involves inflammation of the Achilles tendon with signs of degenerative changes. It is believed its occurrence is associated with disruption of blood flow (Buschbacher, Prahlow & Dave, 2009).

To be continued in my next blog

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Catherine D'Aoust at GAIA Adventures, Kinesiologist, Workshops
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