The painful Achilles tendon is a common presentation in orthopaedic and sports medicine clinics. Traditionally described as "Achilles tendonitis" it is now recognised that the inflammatory process is absent in most patients, and that this is a degenerative condition with attempted repair.
There are a number of typical patient populations:
- pain, swelling and crepitus in the paratenon in athletes
- pain in the body of the tendon, usually 2-6cm above the insertion and often with a tender swelling
- pain and swelling in the insertion itself, often with a superior/lateral calcaneal prominence (Haglund's deformity)
- acute rupture is dealt with separately