Achilles tendinitis and tendinosis are usually caused by a sudden increase or repetitive activity involving the Achilles tendon. Such activity puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, as well as overuse from certain activities such as sports, the body is unable to repair the injured tissue. The structure of the tendon is then altered, resulting in continued pain and swelling. What makes things worse is much of the Achilles tendon does not have a direct blood supply, so healing the damage is much more difficult.
Athletes are at a high risk for developing Achilles tendon disorders. Achilles tendinitis and tendinosis are also common in individuals whose work puts stress on their ankles and feet, such as manual laborers. With the increased number people out there doing activities such as CrossFit and high-intensity, explosive workouts, the numbers of Achilles injuries is increasing.
Additionally, people with excessively pronated or flattened feet have a tendency to develop Achilles tendinitis and tendinosis due to the greater demands placed on the tendon when walking. The Achilles tendon not only has a north-south stretch placed on it, it also has a twisting force as well. To an area with relatively little blood flow, this only makes things worse. If these individuals wear shoes without adequate stability, their overpronation could further aggravate the Achilles tendon.
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