Introduction
Tendo-Achilles Tendon Peritendinitis is an overuse injury affecting the tissues surrounding the Achilles tendon. It is commonly seen in athletes, runners, and individuals involved in repetitive loading activities. Early diagnosis and acquiring physiotherapy management are necessary to prevent chronic pain and functional limitation.
Definition
Tendo-Achillis tendon peritendinitis refers to inflammation of the peritendon—the connective tissue sheath surrounding the Achilles tendon—without primary degeneration of the tendon fibers themselves.
Pathophysiology
Repetitive micro-trauma, sudden increase in training intensity, improper footwear, or poor biomechanics lead to irritation of the peritendon. This causes inflammatory changes, increased vascularity, and thickening of surrounding tissues, resulting in pain and restricted tendon gliding.
Clinical Features
Patients often report pain along the Achilles tendon during or after activity. Swelling and stiffness are common, particularly in the early stages of movement. The condition may limit walking, running, and stair climbing if untreated.
Signs and Symptoms
• Localized pain along the Achilles tendon
• Swelling and warmth around the tendon
• Morning stiffness or stiffness after rest
• Pain aggravated by activity
• Tenderness on palpation
• Crepitus (grating sensation) in some cases
• Reduced ankle flexibility and strength
Physiotherapy Management
- Physiotherapy plays a vital role in recovery and prevention:
- Activity modification and load management
- Cryotherapy in the acute phase to reduce inflammation
- Stretching exercises for calf muscles
- Ankle and foot mobility exercises
- Eccentric strengthening of the Achilles tendon
- Correction of biomechanical faults
- Footwear assessment and orthotic support if required
- Gradual return-to-activity program
- Education on warm-up and injury prevention
Complications
If not managed properly, peritendinitis may lead to:
- Chronic Achilles pain
- Decesed functional performance
- Tendon thickening and stiffness
- Increased risk of Achilles tendinopathy or rupture
- Prolonged limitation in sports and daily activities
Conclusion
Tendo-Achilles tendon peritendinitis is a treatable overuse condition when identified early. A structured physiotherapy program focusing on inflammation control, strengthening, flexibility, and biomechanics ensures optimal recovery and decreases the risk of recurrence.
Q1. What is Tendo-Achilles tendon peritendinitis?
It is an overuse condition involving inflammation of the peritendon surrounding the Achilles tendon, without damage to the tendon fibers.
Q2. What are the common symptoms of Achilles peritendinitis?
Pain along the Achilles tendon, swelling, morning stiffness, tenderness, and pain that worsens with activity are common symptoms.
Q3. How does physiotherapy help in managing this condition?
Physiotherapy reduces inflammation, improves flexibility and strength, corrects biomechanics, and supports a safe return to activity.