How to Deal With Achilles Tendinopathy


What is Achilles Tendinopathy?

Achilles Tendinopathy is a common condition that is particularly prevalent among runners and other types of athletes. The Achilles is a tendon located around the calf muscles and heel bone that can become injured quite easily due to the fact that it supports a lot of weight throughout the day, particularly when exercising. While this condition is very similar to that of standard tendonitis in the Achilles, the problems caused by this specific condition cannot be treated in the same manner. With Achilles Tendinopathy, it’s difficult for the Achilles to handle loads as it used to. The treatment options available for this problem are designed specifically to attack and correct the issue with supporting high loads.

There are a myriad of symptoms that can be present with a condition such as this, though you will first begin to notice some basic stiffness each morning that dissipates quickly. This stiffness will also be present in instances where you sit down for a lengthy period of time. While most athletes tend to work through this stiffness once they notice it, symptoms will worsen over time if the condition isn’t diagnosed and treated immediately.

It’s important to understand that there are other reasons that you could be experiencing pain in the Achilles tendon, which is why it’s so important to have the issue diagnosed by a doctor as soon as possible. Doing so will allow you to get the right treatment for the issue at hand. The best aspect of getting this condition treated is that the initial diagnosis can be done entirely without the usage of any annoying scans.


While there’s no singular cause for the development of Achilles Tendinopathy, since the injury results from a basic overuse of the tendon, there are several factors that increase your risk of eventually suffering from the condition. Among men and women, men are affected on a more regular basis. While people of all ages can go through an injury like this, it’s primarily seen among people that are in their 30’s or 40’s.

It’s possible that your genetics cause an increase in your chances of developing this pain. If you’ve recently started to work out after a lengthy period of not doing so, there’s a heightened chance that you could be affected by this condition. Additional factors include any changes in the amount of exercise you perform. If you place too much pressure on the Achilles Tendon in a small period of time, you might start to notice the symptoms associated with Tendinopathy.

Treatment Options and How to Deal With This Condition

There are many treatment options available to you if you’ve been recently diagnosed with Achilles Tendinopathy. While the standard treatments available for tendonitis aren’t applicable in this situation, the following remedies are just as effective. While the treatments you’re provided with can differ slightly depending on what the cause for the condition is, all treatments are designed to increase the tendons ability to handle load.

All treatment centers around four areas of focus. These areas of focus include improving load tolerance, manual therapy, bio-mechanical corrections and standard exercises that involve strength training. With this type of injury, it’s essential that treatment is implemented carefully, as too much running could worsen the condition, while too little won’t allow for a boost in load tolerance of the tendon. As you continue to go through the standard treatment, one of the best indicators of whether or not the treatment is working is how much stiffness of the tendon you experience in the morning.
Slow strength training with a heavier load is known to work really well in the treatment of this particular condition. Doing this about three times each week should lead to some notable improvements.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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