Prevalence of Achilles Tendinopathy among Physical Therapists of Pakistan

Prevalence of Achilles Tendinopathy


  • Rafia Rafiq Department of Physical Therapy, Sohail University, Karachi, Pakistan
  • Yumna Ilyas Department of Physical Therapy, Sohail University, Karachi, Pakistan
  • Ayesha Aftab Emergancy Department, Jinnah Medical and Dental College, Karachi, Pakistan
  • Sidra Sohail Department of Physical Therapy, Sohail University, Karachi, Pakistan
  • Kashmala Zia Department of Physical Therapy, Northwest Institute of Health Sciences, Peshawar, Pakistan
  • Sana Batool Department of Physical Therapy, Isra University, Karachi, Pakistan
  • Komal Jamil Department of Physical Therapy, Bahria University of Health Sciences, Karachi, Pakistan



Achilles Tendonopathy, Tendinitis, Point Prevalance, Tendo Calcaneus


It is a degenerative disease that affects the tendon of Achilles, which attaches the gastrocnemius muscle to the heel bone. The rate of prevalence in the general population is about 6 percent, in athletes about 24 percent, 36 percent in short-distance runners, and in middle and long-distance runners about 52 percent. Objective: To determine the frequency of Achilles tendinopathy in Physical therapists of Pakistan. Methods: The cross-sectional study was done through an online survey among the Physical Therapists of Pakistan. The estimated sample size calculated from the software was 449 participants. The sampling technique used in this study was convenient. The data was collected through a  validated questionnaire named a Victorian Institute of Sports Assessment- Achilles( VISA-A) measurement tool, ranging from 0 to 100 in which higher scores showed least symptoms while lower scores showed severe symptoms. Statistical analysis was done through SPSS version 23.0. Results: Out of 449 research participants between the ages of 22 to 50 years were evaluated through a validated questionnaire and the result shows 298 (66.36%) of participants participated in sports activities and the level of pain was evaluated as 95(21.15%) of participants fell in healthy, 238(53%) in mild, 97(21.60%) in moderate however 19(4.23%) participants fall in severe category of pain. Conclusions: Our study concluded that the occurance of Achilles tendinopathy is uncommon among the physical therapists population of Pakistan.


Patch DA, Andrews NA, Scheinberg M, Jacobs RA, Harrelson WM, Rallapalle V et al. Achilles tendon disorders: An overview of diagnosis and conservative treatment. Journal of the American Academy of PAs. 2023 Oct; 36(10): 1-8. doi: 10.1097/01.JAA.0000977720.10055.c4.

Radovanović G, Bohm S, Arampatzis A, Legerlotz K. In Achilles Tendinopathy the Symptomatic Tendon Differs from the Asymptomatic Tendon While Exercise Therapy Has Little Effect on Asymmetries—An Ancillary Analysis of Data from a Controlled Clinical Trial. Journal of Clinical Medicine. 2023 Jan; 12(3): 1102. doi: 10.3390/jcm12031102.

Mylle I, Crouzier M, Hollville E, Bogaerts S, Vanwanseele B. Triceps surae muscle forces during dynamic exercises in patients with Achilles tendinopathy: A cross‐sectional study. Scandinavian Journal of Medicine and Science in Sports. 2023 Nov; 33(11): 2219-29. doi: 10.1111/sms.14444.

Dungkong S. Current Physical Therapy Management and Clinical Evaluation for Achilles Tendinopathy. Siriraj Medical Journal. 2023 May; 75(5): 399-406. doi: 10.33192/smj.v75i5.260948.

Bizzoca D, Brunetti G, Moretti L, Piazzolla A, Vicenti G, Moretti FL et al. Polydeoxyribonucleotide in the Treatment of Tendon Disorders, from Basic Science to Clinical Practice: A Systematic Review. International Journal of Molecular Sciences. 2023 Feb; 24(5): 4582. doi: 10.3390/ijms24054582.

Hong JY, Kang C, Kim TG, Yi JW, Song JH, Lee GS et al. Risk Factors for Contralateral Tendon Rupture in Patients With Acute Achilles Tendon Rupture. The Journal of Foot and Ankle Surgery. 2023 Apr; 62(5): 779-784. doi: 10.1053/j.jfas.2023.03.008.

Janowski AJ, Post AA, Heredia-Rizo AM, Mosby H, Dao M, Law LF et al. Patterns of movement-evoked pain during tendon loading and stretching tasks in Achilles tendinopathy: A secondary analysis of a randomized controlled trial. Clinical Biomechanics. 2023 Oct; 109: 106073. doi: 10.1016/j.clinbiomech.2023.106073.

Sancho I, Willy RW, Morrissey D, Malliaras P, Lascurain-Aguirrebeña I. Achilles tendon forces and pain during common rehabilitation exercises in male runners with Achilles tendinopathy. A laboratory study. Physical Therapy in Sport. 2023 Mar; 60: 26-33. doi: 10.1016/j.ptsp.2023.01.002.

Williamson PM, Yeritsyan D, Peacock T, Chainani P, Momenzadeh K, Asciutto D et al. A passive ankle dorsiflexion testing system to assess mechanobiological and structural response to cyclic loading in rat Achilles tendon. Journal of Biomechanics. 2023 Jul; 156: 111664. doi: 10.1016/j.jbiomech.2023.111664.

Merry K, MacPherson M, Vis-Dunbar M, Whittaker JL, Silbernagel KG, Scott A. Identifying characteristics of resistance-based therapeutic exercise interventions for Achilles tendinopathy: A scoping review. Physical Therapy in Sport. 2023 Jul; 63: 73-94. doi: 10.1016/j.ptsp.2023.06.002.

Corrigan P, Hornsby S, Pohlig RT, Willy RW, Cortes DH, Silbernagel KG. Tendon loading in runners with Achilles tendinopathy: relations to pain, structure, and function during return‐to‐sport. Scandinavian Journal of Medicine & Science in Sports. 2022 Aug; 32(8): 1201-12. doi: 10.1111/sms.14178.

Docking SI, Rosengarten SD, Daffy J, Cook J. Structural integrity is decreased in both Achilles tendons in people with unilateral Achilles tendinopathy. Journal of Science and Medicine in Sport. 2015 Jul; 18(4): 383-7. doi: 10.1016/j.jsams.2014.06.004.

Van der Vlist AC, Breda SJ, Oei EHG, Verhaar JAN, de Vos RJ. Clinical risk factors for Achilles tendinopathy: a systematic review. British Journal of Sports Medicine. 2019 Nov; 53(21):1 352-1361. doi: 10.1136/bjsports-2018-099991.

Lagas IF, van der Vlist AC, van Oosterom RF, van Veldhoven PLJ, Reijman M, Verhaar JAN, de Vos RJ. Victorian Institute of Sport Assessment-Achilles (VISA-A) Questionnaire-Minimal Clinically Important Difference for Active People With Midportion Achilles Tendinopathy: A Prospective Cohort Study. The Journal of Orthopaedic & Sports Physical Therapy. 2021 Oct; 51(10): 510-6. doi: 10.2519/jospt.2021.10040.

Kakade A, Rayjade A. Prevalence of Achilles Tendinopathy in Building Construction Workers. Chettinad Health City Medical Journal (E-2278-2044 & P-2277-8845). 2023 Jun; 12(2): 99-102. doi: 10.24321/2278.2044.202335.

Meh J, Bizovičar N, Kos N, Jakovljević M. Work-related musculoskeletal disorders among Slovenian physiotherapists. Journal of Health Sciences. 2020 May; 10(2): 115-24. doi: 10.17532/jhsci.2020.880.

Heyward OW, Rabello LM, van der Woude L, van den Akker-Scheek I, Gokeler A, van der Worp H et al. The effect of load on Achilles tendon structure in novice runners. Journal of Science and Medicine in Sport. 2018 Jul; 21(7): 661-5. doi: 10.1016/j.jsams.2017.11.007.

Javed S, Amjad MR, Mehmood A, Asghar HM, Javaid M, Avaid A. Prevalence of Achilles Tendinopathy in Female Nurses in Lahore-Pakistan. Pakistan Journal of Medical & Health Sciences. 2022 Jul; 16(07): 88. doi: 10.53350/pjmhs2216788.

Riel H, Lindstrøm CF, Rathleff MS, Jensen MB, Olesen JL. Prevalence and incidence rate of lower-extremity tendinopathies in a Danish general practice: a registry-based study. BMC Musculoskeletal Disorders. 2019 May; 20(1): 1-6. doi: 10.1186/s12891-019-2629-6.

Chimenti RL, Post AA, Silbernagel KG, Hadlandsmyth K, Sluka KA, Moseley GL et al. Kinesiophobia Severity Categories and Clinically Meaningful Symptom Change in Persons With Achilles Tendinopathy in a Cross-Sectional Study: Implications for Assessment and Willingness to Exercise. Front Pain Research (Lausanne). 2021 Sep; 2: 739051. doi: 10.3389/fpain.2021.739051.

Sprague AL, Awokuse D, Pohlig RT, Cortes DH, Grävare Silbernagel K. Relationship between mechanical properties (shear modulus and viscosity), age, and sex in uninjured Achilles tendons. Translational Sports Medicine. 2020 Jul; 3(4): 321-7. doi: 10.1002/tsm2.148.

Jin Z, Wang D, Zhang H, Liang J, Feng X, Zhao J et al. Incidence trend of five common musculoskeletal disorders from 1990 to 2017 at the global, regional and national level: results from the global burden of disease study 2017. Annals of the Rheumatic Diseases. 2020 Aug; 79(8): 1014-22. doi: 10.1136/annrheumdis-2020-217050.

Mildren RL, Schmidt ME, Eschelmuller G, Carpenter MG, Blouin JS, Inglis JT. Influence of age on the frequency characteristics of the soleus muscle response to Achilles tendon vibration during standing. The Journal of Physiology. 2020 Nov; 598(22): 5231-43. doi: 10.1113/JP280324.

Ryan D, Rio E, O'Donoghue G, O'Sullivan C. The effect of combined action observation therapy and eccentric exercises in the treatment of mid-portion Achilles tendinopathy: study protocol for a feasibility pilot randomised controlled trial. Pilot Feasibility Studies. 2022 Feb; 8(1): 30. doi: 10.1186/s40814-022-00981-w.

Yeh CH, Calder JD, Antflick J, Bull AM, Kedgley AE. Maximum dorsiflexion increases Achilles tendon force during exercise for midportion Achilles tendinopathy. Scandinavian Journal of Medicine & Science in Sports. 2021 Aug; 31(8): 1674-82. doi: 10.1111/sms.13974.

Nabipour M, Sawicki GS, Sartori M. Predictive Control of Peak Achilles Tendon Force in a Simulated System of the Human Ankle Joint with a Parallel Artificial Actuator During Hopping. IEEE International Conference on Rehabilitation Robotics. 2023 Sep; 2023: 1-6. doi: 10.1109/ICORR58425.2023.10304771.



DOI: 10.54393/tt.v4i04.174
Published: 2023-12-31

How to Cite

Rafiq, R., Ilyas, Y., Aftab, A., Sohail, S., Zia, K., Batool, S., & Jamil, K. (2023). Prevalence of Achilles Tendinopathy among Physical Therapists of Pakistan: Prevalence of Achilles Tendinopathy. THE THERAPIST (Journal of Therapies &Amp; Rehabilitation Sciences), 4(04), 19–23.


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