Classification of Achilles Tendonitis

Classification:

Depending upon the area of pain over Achilles Tendon, the disorder can be classified into two types: (i) Acute or Non-insertional Achilles Tendonitis (ii) Chronic or insertional Achilles Tendonitis.

(i) Acute Achilles Tendonitis.:

Pain developed towards the point of origin of Achilles Tendon is said to be Acute Achilles Tendonitis. Normally, moderate pain arises abruptly 2-6 cm above Achilles Tendon inserts. This sharp ache occurs during beginning of any activity and later becomes severe due to extreme stress on Achilles Tendon. There are three levels of Non-insertional Tendonitis.

Level-I (Achilles Peritendinitis)

In this stage, a slight/normal distortion occur on Paratenon and nearby sensitive tissue ‘bursa’.

Paratenon - An areolar tissue present between tendon and tendon sheath.

Bursa - A tiny fluid-filled sac situated between joints.

Level-II (Peritendinitis)

If you analyse the tendon at this phase, the changeable amounts of necrosis (death cells/tissues), longitudinal tears, tendon rupture can be seen. This is because, severe swelling of the paratenon lead to enzyme degradation.

Level-III (Achilles tendinosis)

When there is degeneration of proteins in tissues at the Achilles bone joint, it leads to a serious problem often referred as ‘Achilles Tendinosis’.

Chronic Achilles Tendonitis:

Chronic Achilles Tendonitis is a problem/swelling at the front end of the tissue joining the heel bone (calcaneus) which results in enlargement of posterior heel or tendon. This type of Achilles tendonitis has got peculiarity compared to the acute tendonitis by the nature of pain caused. This is because acute tendonitis creates pain at a specific point at the tendon but Chronic Tendonitis develops pain mostly on the back side of heel where Achilles bone starts.