Achilles tendinopathy is caused by repeated or excessive stress (pulling or contracting) on the Achilles tendon. The incidence is higher in people who perform plantarflexion for long periods of time (e.g. hurdling, long-distance running) than in the general population. In addition, as people age, the strength of the Achilles tendon decreases and becomes more susceptible to damage. In particular, those who are normally less active and suddenly engage in strenuous exercise have a higher probability of developing Achilles tendinopathy.
In addition to old age, men, factors such as flat feet, obesity, cold weather, unsuitable sports shoes and taking certain antibiotics (quinolones) can also increase the risk of getting Achilles tendinopathy.