Achilles tendinopathy

Nicola Maffulli, Umile Giuseppe Longo, Anish Kadakia, Filippo Spiezia*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

71 Scopus citations


Background: Achilles Tendinopathy (AT) is essentially a failed healing response with haphazard proliferation of tenocytes, abnormalities in tenocytes with disruption of collagen fibers, and subsequent increase in non-collagenous matrix. Methods: The diagnosis of Achilles tendinopathy is clinical, and MRI and utrasound imaging can be useful in differential diagnosis. Conservative manegement, open surgery or minimally invasive techniques are available. Injections and physical therapy are also vauable options. Results: Eccentric exercises are useful tools to manage the pathology. If the condition does not ameliorate, shock wave therapy, or nitric oxide patches might be considered. Peritendinous injections or injections at the interface between the Achilles tendon and Kager's triangle could be considered if physical therapy should fail. Surgery is indicated after 6 months of non-operative management. Conclusions: The clinical diagnosis and management of AT are not straightforward. Hence, patients should understand that symptoms may recur with either conservative or surgical approaches.

Original languageEnglish (US)
Pages (from-to)240-249
Number of pages10
JournalFoot and Ankle Surgery
Issue number3
StatePublished - Apr 2020


  • Achilles tendinopaty
  • Ankle
  • Injections
  • Sports trauma
  • Tendon

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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