Foot Disorders - Achilles Tendinopathy

Question 1

What is Achiles Tendinopathy/Tendinitis?

Answer 1

Damage, Swelling, Inflammation and Reduced Functioning in the Achilles Tendon.

Question 2

What are the 2 Types of Achilles Tendinopathy?

Answer 2

1. Insertion Tendinopathy (within 2cm of Insertion Point on Calcaneus).
2. Mid-Portion Tendinopathy (2-6cm above Insertion Point).

Question 3

Anatomy of the Achilles Tendon (2).

Answer 3

1. Connects Calf Muscles (Gastrocnemius and Soles) to Heel.

2. Flexion of Calf = Plantar Flexion of Ankle.

Question 4

Risk Factors of Achilles Tendinopathy (5).

Answer 4

1. Sports Stressing Achilles.
2. Inflammatory Conditions.
3. Diabetes.
4. Raised Cholesterol (Tendon Xanthomata)
5. Fluoroquinolone Antibiotics e.g. Ciprofloxacin, Levofloxacin.

Question 5

Investigations of Achilles Tendinopathy (2).

Answer 5

1. Clinical Diagnosis.

2. Exclude Achilles Tendon Rupture using Simmonds’ Calf Squeeze Test.

Question 6

Management of Achilles Tendinopathy (7).

Answer 6

1. Rest.
2. Ice.
3. Physiotherapy.
4. Analgesia.
5. Orthotics e.g. Insoles.
6. Extracorporeal Shock Wave Therapy.
7. Surgery : Remove Nodules and Adhesions.

Question 7

Why are Steroid Injections avoided?

Answer 7

Risk of Tendon Rupture.