Management of Achilles tendinopathy in runners-LER 
By Howard Kashefsky, DPM
Achilles tendinopathy is a common lower extremity injury in athletes as well as nonathletes. The Achilles tendon is often a site of injury in runners and is the second-most common running-related musculo¬skeletal injury, after medial tibial stress syndrome, with an incidence of 9.1% to 10.9%.
1 The lifetime risk in former elite male distance runners is 52%.
2 Factors that may contribute to Achilles tendinopathy include overuse, systemic disease, older age, sex, body composition, and biomechanics.
3 Elevated biomechanical load has been shown to cause both microscopic and macroscopic failures.4-6


1. Lopes AD, Hespanhol Junior LC, Yeung SS, Costa LO. What are the main running-related musculoskeletal injuries? A systematic review. Sports Med 2012;42(10):891-905.
2. Zafar MS, Mahmood A, Maffulli N. Basic science and clinical aspects of Achilles tendinopathy. Sports Med Arthrosc 2009;17(3):190-197.
3. Magnan B, Bondi M, Pierantoni S, Samaila E. The pathogenesis of Achilles tendinopathy: a systematic review. Foot Ankle Surg 2014;20(3):154-159.
4. O’Brien M. Functional anatomy and physiology of tendons. Clin Sports Med 1992;11(3):505-520.