Achilles Tendon Injuries and Tendonitis 

  • Author: Anthony J Saglimbeni, MD; Chief Editor: Consuelo T Lorenzo, MD   more...
 
Updated: Jan 18, 2012
 

Background

Achilles tendon rupture is a complete disruption of the Achilles tendon, observed most commonly in patients aged 30-50 years, usually occurring at a point 4-5 cm proximal to the calcaneus. This area above the calcaneus is the zone of poor blood flow in the tendon.

Achilles tendonitis is inflammation of the tendon or paratenon, usually resulting from overuse associated with a change in playing surface, footwear, or intensity of an activity. Terminology used to describe this condition currently is subject to debate. Some evidence suggests that tendinopathy or tendinosis are better terms, as inflammation, suggested by the term tendonitis, may not play a key role in this process.

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Pathophysiology

Areas of degeneration may predispose patients to Achilles tendon ruptures (eg, from chronic tendonitis or tendinopathy), or prior cortisone injections may lead to tendon rupture. Common pathophysiology of overuse syndromes applies to Achilles overuse injuries.

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Epidemiology

Frequency

United States

Exact frequency varies and has been reported at 6 cases per 100,000 persons in Scotland to up to 37 cases per 100,000 persons in Denmark. The condition commonly occurs in the 30- to 44-year-old recreational athletes, and as many as 72-89% of injuries occur during athletic ventures. Some reports show Achilles tendon rupture to be the third most common tendon rupture.[1]

Mortality/Morbidity

Mortality is unreported. Morbidity can include chronic shortening or contracture with Achilles tendon rupture and tendon degeneration with tendonitis.

Sex

Achilles tendon injuries are more prevalent in males at a ratio of 6:1, perhaps due to sports-specific involvement.

Age

This injury usually is observed in recreational athletes aged 30-50 years. As with gastrocnemius tears and strains, this population often is active only intermittently, and they often still challenge their bodies with high-force activities, predisposing them to these kinds of injuries.

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Contributor Information and Disclosures
Author

Anthony J Saglimbeni, MD  President, South Bay Sports and Preventive Medicine Associates; Private Practice; Team Internist, San Francisco Giants; Team Internist, West Valley College; Team Physician, Bellarmine College Prep; Team Physician, Presentation High School; Team Physician, Santa Clara University; Consultant, University of San Francisco, Academy of Art University, Skyline College, Foothill College, De Anza College

Anthony J Saglimbeni, MD, is a member of the following medical societies: California Medical Association and Santa Clara County Medical Association

Disclosure: South Bay Sports and Preventive Medicine Associates, Inc Ownership interest Other

Coauthor(s)

Christian J Fulmer, DO  Private Practice in Sports and Family Medicine; Team Physician, Valley Christian High School

Christian J Fulmer, DO is a member of the following medical societies: American Academy of Family Physicians, American Academy of Osteopathy, American Medical Society for Sports Medicine, and American Osteopathic Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM  President and Director, Georgia Pain Physicians, PC; Clinical Associate Professor, Department of Physical Medicine and Rehabilitation, Emory University School of Medicine

Robert E Windsor, MD, FAAPMR, FAAEM, FAAPM is a member of the following medical societies: American Academy of Pain Medicine, American Academy of Physical Medicine and Rehabilitation, American College of Sports Medicine, American Medical Association, International Association for the Study of Pain, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Michael T Andary, MD, MS  Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: Allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Kelly L Allen, MD  Medical Director, Medevals

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD  Physiatrist, Department of Physical Medicine and Rehabilitation, Alegent Health Immanuel Rehabilitation Center

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

References

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