September 2021 Newsletter



Achilles Tendonitis or Tendonosis?


The Achilles tendon is the largest and strongest tendon in the body.  It connects the powerful muscles of the calf with the calcaneus bone of the heel.  The tendon transmits force from the calf muscles to the heel to provide movement of the foot primarily during the push off phase of the gait cycle. 



The two main problems that develop with the Achilles tendon is an acute tendonitis or chronic tendonosis.  A tendonitis denotes inflammation within and surrounding the tendon usually following an acute strain or a relatively large increase in training volume over a short period of time.  Characteristics of acute tendonitis include:


  • Redness
  • Swelling
  • Tenderness
  • Increased pain/stiffness with inactivity or in the morning
  • Pain or discomfort early with activity

A tendonosis is considered a chronic condition and is the result of an accumulation of micro-trauma, or small tears in the tendon from repetitive over overuse.  Over time scar tissue can develop and cause the tendon to weaken.  A rupture of a tendon is more common in degenerated tissue.  Over 90% of all Achilles tendon ruptures happen in this chronic state.  Achilles tendonitis or tendonosis can result from the following:


  • Excessive training volume
  • Pronation/instability issues
  • Improper running technique
  • Improper/worn footwear
  • Weaknesses/imbalances

Treatment of a tendonosis should address:


  • Stabilizing/reducing training volume
  • Muscular and tendon scar tissue adhesions
  • Mobility of the joints of the feet
  • Stability of the arches of the feet
  • Footwear
  • Corrective rehabilitative exercise

An exercise to increase blood flow to the tendon and help realign the collagen fibers of the tendon is an eccentric (lowering) calf raise.  Standing on the edge of a step with your heels hanging off, raise yourself up on both feet, then slowly lower your heel down into a calf stretch just on one foot.  Repeat by lifting yourself up with both feet.  This is one repetition.  This exercise can result in minor discomfort, but should not cause excessive pain.  Each repetition should take 6 seconds to lower.  Perform 2-3 sets for 15-20 repetitions daily.    

Active Performance Chiropractic focuses on the diagnosis, treatment, and rehabilitation of athletic-related injuries. Treatment is a unique blend of Active Release Techniques, traditional chiropractic therapy, and physical rehabilitation designed to match each patient’s goals and lifestyle.