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Causes of Achilles Tendonitis?

Causes of Achilles Tendonitis / Tendinosis

Classically the main causes of Achilles tendonitis are associated with training factors and overuse.
Then there are the intrinsic factors of the athlete themselves – biomechanics, muscle weakness, medical conditions, degenerative changes etc.
The extrinsic causes of Achilles tendonitis would include footwear and perhaps use of antibiotics.

Training Causes of Achilles Tendonitis

  • an increased frequency of running over a short period of time
  • a sudden increase in the length of runs
  • a rapid and sudden increase in running speed
  • repeated running uphill as part of a training regime
  • conversely repeated runs downhill!


Intrinsic Causes of Achilles Tendonitis

Factors that can predispose a runner to Achilles problems are

  • gait abnormalities such as :-
  • excessive or poorly controlled pronation
  • restricted dorsiflexion
  • tight calf
  • ankle joint arthritis
  • age related degenerative changes in the tendon
  • muscle imbalances
  • weak calf muscles
  • weak Tibialis Posterior muscle
  • weak buttock muscles
  • being overweight

Medical conditions associated with an increased risk of Achilles problems are

  • rheumatoid arthritis
  • gout
  • pseudogout
  • subtalar malalignment
  • restless legs syndrome
  • Haglund’s Deformity


Extrinsic Causes of Achilles Tendonitis

  • inappropriate footwear
  • wrong type of shoes
  • worn shoes
  • certain antibiotics – quinolones like
  • Avelox, Ciprofloxacin, Factive, Floxin, Levaquin, Noroxin, and Proquin in the USA


Who Gets Non-Insertional Achilles Tendinosis

  • Males up to 7 times more likely to get it than females
  • Athletes in their 20s to 30s with high mileage
  • Left leg more often than right leg (possibly due to majority being right-handed)
  • Most reported injury in the over 40s group of runners

Insertional Achilles Tendonitis

  • tends to occur more frequently among older athletes in their 50s and 60s
  • patients tend to be overweight
  • often occurs with a retrocalcaneal bursitis (inflammation of a fluid filled sac immediately behind tendon insertion)
  • a Haglund’s deformity (a bony protruberance of the Calcaneum) predisposes the tendon to irritation
  • more likely to occur in the cavus foot (high arched)

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One Response to “Causes of Achilles Tendonitis?”

  1. davenycity Says:

    great blog thank you

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