Achilles Tendinopathy

Abstract

Achilles tendinopathy is a degenerative tendinous disorder that commonly involves the hypovascular area located from 2 to 6 cm above the calcaneal insertion. It is commonly considered the result of multiple micro-tears that do not heal because of poor tendon vascularity. Achilles tendinopathy is a common condition in the adult population. In 59 % of patients, it is related to sports activities, and 53 % of them are runners. Some intrinsic factors (e.g., gender, age, and overweight) and extrinsic factors (e.g., functional overload, poor footwear, and training errors) play an important role in the development of chronic tendinopathy. Achilles tendinopathy is characterized by degenerative changes that could be located along the tendon course or at the enthesis. Histological features in the early stages of the disease are focal areas of asymptomatic intratendineous damage without signs of inflammation. Histological appearance of degenerative damage begins and progresses long before onset of symptoms. This delay causes late therapeutic approaches to be less successful.