{"id":6722,"date":"2023-11-21T14:02:23","date_gmt":"2023-11-21T13:02:23","guid":{"rendered":"https:\/\/sportambulatorium.wien\/?p=6722"},"modified":"2026-10-15T16:23:42","modified_gmt":"2026-10-15T14:23:42","slug":"chron-achillodynie","status":"publish","type":"post","link":"https:\/\/sportambulatorium.wien\/en\/chron-achillodynie\/","title":{"rendered":"Thickening of the Achilles Tendon & Achilles Tendinopathy"},"content":{"rendered":"

Chronic Achilles tendinopathy: Causes of Achilles tendon thickening<\/h2>\n\n\n\n

Pathology: Collagen Changes and Risk of Achilles Tendon Rupture<\/h3>\n\n\n\n

The tendon is usually thickened in the chronic stage. The chronic inflammation causes lasting pain (often a deep dull pain) and leads to a weakening of the Achilles tendon. The cause of this lies in the fact that the Type 1 collagen that makes up 95% of collagen in a healthy Achilles tendon has been replaced by the significantly weaker Type 3 collagen. This also happens in the context of Achilles tendon injuries, as the fibroblasts that migrate from the blood vessels as a reaction to the injury primarily produce Type 3 collagen. The Achilles tendon can sometimes later tear as a result.

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Image:<\/strong> MRI of chronic achillodynia <\/figcaption><\/figure><\/div>\n\n\n

Causes of Pain Due to Vascular and Nerve Invasion<\/h3>\n\n\n\n

New research shows that an additional problem is that growing blood vessels, which should heal the Achilles tendon, also pick up small nerve endings, which can react to pulling with severe pain.<\/p>\n\n\n\n

Treating Chronic Achilles Tendonitis <\/h3>\n\n\n\n

Die besten Ergebnisse erzielt man in diesem Stadium mit einer Kombination aus t\u00e4glichen exzentrischen Muskel\u00fcbungen, podologischen Einlagen (die v.a. im t\u00e4glichen Leben getragen werden sollten) und Physiotherapie – in Kombination mit dem Repuls Tiefenstrahler (s.o.). <\/p>\n\n\n\n

Eccentric muscle exercises: A Swedish study showed that patients with chronic Achilles tendon symptoms were able to achieve a full recovery within 12 weeks if they carried out eccentric exercises consistently. It was astounding that all the athletes studied had already had treatment-resistant symptoms for two years. \n<\/p>\n\n\n\n

The exercise involves standing on a step with the ball of the foot and lifting the heel slowly upwards (one can also do it with both foot for stability) and then slowly lowering the heel and pressing it down as far as possible, significantly stretching the Achilles tendon. The authors of the study also recommended wearing a heavy rucksack to add more weight to the stretch. Dr. G\u00e4bler, however, feels that this is somewhat excessive, as the stretching is the important part, not the lifting the heel. <\/p>\n\n\n\n

Such muscle exercises cause small vessels to necrotise on the one hand (and therefore also the painful nerve endings), and on the other, the exercises increase the production of Type 1 collagen, which heals and strengthens the tendon.\n<\/p>\n\n\n\n

It often takes months, however, until symptoms actually improve, which is obviously very detrimental to any keen runner, as only very limited running is permitted during this time.\n<\/p>\n\n\n\n

See also - Video<\/a><\/p>\n\n\n\n

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