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Achilles Tendinitis

The Achilles tendon connects the calf muscle to the back of the heel. Achilles tendinitis is a common injury that makes the tendon swell, stretch, or tear.

PubMed Health Glossary
(Source: NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases)

About Achilles Tendinitis

Achilles tendon injuries involve an irritation, stretch, or tear to the tendon connecting the calf muscle to the back of the heel. Achilles tendinitis is a common overuse injury, but can also be caused by tight or weak calf muscles or any condition that causes the tendon to become less flexible and more rigid, such as reactive arthritis or normal aging.

Achilles tendon injuries can happen to anyone who regularly participates in an activity that causes the calf muscle to contract, like climbing stairs or using a stair-stepper, but are most common in middle-aged "weekend warriors" who may not exercise regularly. Among professional athletes, most Achilles injuries seem to occur in quick-acceleration or jumping sports like football, tennis, and basketball, and almost always end the season's competition for the athlete.

Achilles tendinitis can be a chronic condition. It can also cause what appears to be a sudden injury. Tendinitis is the most common factor contributing to Achilles tendon tears. When a tendon is weakened by age or overuse, trauma can cause it to rupture. These injuries can be so sudden and agonizing that they have been known to bring down charging professional football players in shocking fashion. NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases

What works? Research summarized

Evidence reviews

Eccentric exercise protocols for chronic non-insertional Achilles tendinopathy: how much is enough?

Eccentric exercises for the calf muscles have been shown to be effective for chronic non-insertional Achilles tendinopathy (AT). However, the relative effectiveness of various dosages is unknown. A systematic review of randomized-controlled trials (RCTs) was designed to determine whether an optimum dose of eccentric exercises could be recommended. Three selected RCTs showed positive effects of very similar eccentric exercise protocols for chronic non-insertional AT. Owing to insufficient reported compliance data, a conclusion on the relative effectiveness of various compliances was not feasible. According to our review, the relative effectiveness of various dosages of eccentric exercises for AT is still unclear. However, it appears that highly variable compliance rates result in similar positive outcomes; these findings, therefore, highlight the need for further investigations.

The role of platelets in the treatment of Achilles tendon injuries

To systematically review the current in-vivo evidence for the use of platelet-concentrates (PRP) in the treatment of Achilles tendinopathy and Achilles tendon ruptures in animal models and human applications. A systematic search of PubMed, CINAHL, EMBASE, CCTR, and CDSR was performed for animal and human studies on the effect of platelet-concentrates in the treatment of Achilles tendinopathy and ruptures using the terms "Achilles tendon and platelet." The systematic search revealed a total of 149 papers. After excluding duplicates and cases of overlapping data, studies not focusing on in vivo evidence in terms of treatment or outcome, studies without any intervention, studies with unacceptable high attrition, one Chinese and one Swedish study, the remaining 14 manuscripts were included. The key finding of our study is evidence in support of a statistically significant effect of platelet concentrates in the treatment of Achilles tendon ruptures in vivo in animal models and human application, consistent with a medium to large sized effect. This effect is most likely attributable to fastened and enhanced scar tissue maturation. There was no evidence for a beneficial effect of platelets in Achilles tendinopathy.

What is the clinical effectiveness and cost-effectiveness of conservative interventions for tendinopathy? An overview of systematic reviews of clinical effectiveness and systematic review of economic evaluations

This study aims to summarise the evidence concerning the clinical effectiveness and cost-effectiveness of conservative interventions for lateral elbow tendinopathy (LET). Clinical effectiveness evidence continues to suggest uncertainty as to the effectiveness of many conservative interventions for the treatment of LET. Although new randomised controlled trial (RCT) evidence has been identified with either placebo or active controls, there is uncertainty as to the size of effects reported within them owing to small sample size. Conclusions regarding cost-effectiveness are also unclear. Future work should be on conducting large scale, good-quality clinical trials using a core set of outcome measures (for defined time points) and appropriate follow-up. Subgroup analysis of existing RCT data may be beneficial to ascertain whether or not certain patient groups are more likely to respond to treatments.

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Summaries for consumers

Injection treatment for painful Achilles tendons in adults

The Achilles tendon connects the calf muscles to the heel bone. Painful and stiff Achilles tendons are common overuse injuries in people undertaking sports, such as running, but also occur for other reasons in inactive people. The underlying cause is an imbalance between the damage and repair processes in the tendon. Painful Achilles tendons are often disabling and can take a long time to get better. Many treatments exist for this condition and this review set out to find out whether treatment with an injection, with a variety of agents, decreases pain and allows people to return to their previous activities.

Platelet‐rich therapies for musculoskeletal soft tissue injuries

Muscle, ligament and tendon injuries frequently occur during activities such as sports, and may be due to tissue degeneration. These injuries are more frequent in particular parts of the body, such as the tendons located in the shoulder, elbow, knee and ankle.

More about Achilles Tendinitis

Photo of an adult

Also called: Achilles tendonitis

Other terms to know:
Achilles Tendon (Calcaneal Tendon), Achilles Tendon Injuries, Tendinitis

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