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)

Return to TOP 10 QUESTIONS ANSWERED