What is the difference between tendinitis and tendinopathy?

The two are almost identical.

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Science has recently discovered that there isn't always inflammation present in tendon pain.

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"So when there is tendon pain without inflammation, it is called tendinopathy. When there is tendon pain with inflammation of the tendon, then it is called tendinitis."

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In both cases, whether it's tendinitis or tendinopathy, the treatment approach isn't very different. Therefore, we will include tendinopathies and tendinitis as the same injury.

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What is Achilles tendon tendinopathy?

It's an irritation of the Achilles tendon.

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What is the Achilles tendon?

It's the tendon of the calf muscle that attaches to the heel at the back of the foot.

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What are the causes of Achilles tendon tendinopathy?

This can be caused by:

• Too rapid an overload on the tendon
• Small, repetitive traumas to the tendon

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Here are some classic examples of the development of this pathology:

• Resuming running after winter without proper pacing
• Changing a parameter of your running (speed, elevation, distance)
• Starting to walk a lot when you weren't walking regularly before
• Starting a new sport that involves a lot of jumping (volleyball, basketball)

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What are the symptoms of Achilles tendon tendinopathy?

The most common symptoms are:

• Pain that appears gradually behind the heel in the center, or pain in the tendon between 2 and 6 cm above the heel.
• The pain is worse with the first steps in the morning or after being still for a long time.
• The pain improves with movement but returns if you do too much weight-bearing activity, such as:
  
  • Walking (worse when going uphill)
  • Running (worse when going uphill)
  • Rise up onto your toes.
  • Jumping
• Pain when the tendon is pinched

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How is Achilles tendinopathy diagnosed?

Diagnosis is possible based on the history of your symptoms and a clinical examination. X-rays cannot detect tendinopathy.

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When should I see a physiotherapist for Achilles tendinopathy?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

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You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

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What physiotherapy treatments are available for Achilles tendinopathy?

Your physiotherapist will perform a thorough assessment to determine the precise source of the problem. There are various causes of Achilles tendinopathy.

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Your physiotherapist will assess the following:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

Based on the assessment results, your physiotherapist will:

• Mobilize your joints, muscles, and nerves to reduce pain and improve movement.
• Provide you with specific exercises to retrain the strength and stability of your foot.
• Give you specific exercises to learn how to properly control your movements.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Give you advice for your posture and movements.

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What to do at home for Achilles tendinopathy?

Reduce the duration of activities that cause too much pain temporarily, and then gradually begin to increase the duration afterward.

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If you are a runner, please refer to the blog post on running (link to come) for practical running tips.

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