Tendon Problems

There are a number of different types of tendon problems which can occur. Tendons and ligaments serve different functions. A tendon connects a muscle to a bone. When the muscle contracts, the tendon pulls on the bone and movement occurs at a joint. Ligaments are not dynamic, and act as check-reins to stop a joint moving too far in a particular direction. Although tendons can be thought of as ropes, and are not as dynamic as the muscle, they do have a degree of elasticity. Wear and tear (tendinopathy) of the tendon results in thickening, splitting or even tearing of the tendon. When this occurs the whole unit of muscle and tendon loses elasticity and cannot function properly.


Patients may notice pain, swelling, weakness or poor balance. Sometimes neighbouring tendons, ligaments or joints become secondarily problematic. Types of tendon problems.

Achilles tendinopathy

Pain and discomfort arises just above the heel bone. This is where it has a poor blood supply. Thickening and tenderness of the tendon causes pain and stiffness and is often worse first thing in the morning.

Insertional tendinopathy

This condition occurs when the back of the heel bone, where the tendon inserts onto the bone, becomes painful and swollen. Normally care with shoes, insoles and some physiotherapy is sufficient to treat the problem, however surgery may be needed for the most severe cases of inflammation (bursitis).

Adult flat-foot – Tibialis Posterior tendinopathy

Not every 'fallen arch' or flat foot is due to a tendon problem. However, tendinopathy of the posterior tibial tendon is the most common cause. This tendon runs around the inner ankle bone and attaches to the navicular bone in the instep. It functions like braces to hold up the arch of the foot and if the tendon fails to work effectively, adult flat foot is likely to develop.

Peroneal Tendinopathy

This condition occurs when there is damage to the tendons which run around the outer ankle bone and turn upwards and outwards at the ankle. Pain, swelling and giving-way or ankle instability are the usual complaints from this type of tendon problem.

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