The practical management of Achilles tendinopathy.

The Achilles tendon, named after the legendary warrior and hero of Homer’s Iliad, is the strongest and thickest tendon in the human body. Despite this fact, Achilles tendinopathy is a common overuse injury, particularly in runners and other athletes. Kujala et al showed a 10-fold increase in Achilles injuries in runners compared with age-matched controls. Another study reported the incidence of Achilles tendinopathy in top-level runners as 7% to 9%. The specific factors linking this injury with running include excessive mileage, sudden increase in training intensity, decrease in recovery time, change of running surface, and poor footwear. This injury also is common in athletes who compete in racquet sports, track and field, volleyball, and soccer. Other factors that have been associated with Achilles tendinopathy include various biomechanical deficits, older age, male gender, increased body weight and height, and fluoroquinolone exposure.