Achilles tendonitis is a common ailment for runners and other athletes that rely on jumping and lateral motion power and control.  Typically due to overuse, microscopic tearing of the Achilles tendon occurs, leading to pain, swelling and difficulty walking, especially post-statically.  

But an interesting population has made it into my clinic time and time again with Achilles tendonitis/bursitis, it is not your typical athlete. I am talking about your everyday aging adult that is struggling with osteoarthritis of the knee. I have seen this too many times now to be a coincidence.

In a short review of the literature, I come up with no studies that directly correlate knee OA with Achilles tendon pain, but mechanically it makes sense. One of the most common compensations/deformities of knee OA is the loss of full knee extension ROM. These patients begin walking with mild knee flexion contractures. Sometimes visible  and sometimes not. It is my belief that the chronic anterior tibial translation becomes the “overuse” stress to the Achilles and thus becomes the cause of the Achilles pain. 

With physical therapy intervention, combining functional strengthening and restoration of adequate ROM of the LE, we have seen good success with resolving Achilles tendon pain and at the same time, improving the associated OA related pain.

Photo Credit: arinas74 on rgbstock

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