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Achillodynia (Achilles tendon pain) is a significant source of disability to many people taking part in sports. Papers in the English language published since 1986 are reviewed here, grouped into specific subject areas including biomechanics, pathology, general clinical presentations, experimental treatments, steroids, podiatry and surgery. While there has been no dramatic breakthrough in the field, there have been various interesting advances with particular reference to imaging and conservative management, which will hopefully stimulate further studies. Many problems of Achilles tendon lesions in athletes remain unsolved, however, and much is yet to be done to provide adequate and generally effective methods of prevention and conservative treatment.

Sport for all" means sports injuries for all. Facilities for their treatment are inadequate in the United Kingdom. An analysis of 1750 cases indicated that many injuries are specific to sporting activity and that the problem of their treatment cannot effectively be solved by the organization of special clinics for sportsmen based on existing services. There is a case for establishing regional or area clinics manned by appropriately trained, recognized, and committed specialists.

Achilles tendon pain is a common cause of disability in sportsmen. The majority of cases are due to overuse injury often exacerbated or precipitated by specific and recognisable factors. A variety of pathologies is demonstrable in Achilles tendon pain which accounts for the considerable variation in the described natural history of the disease. The study of patients with Achilles tendon pain is almost impossible unless an accurate diagnosis is made first. The specific factors of the various conditions demonstrated as causes of Achilles tendon pain are set out and the value of different laboratory and other investigations indicated in the particular pathological conditions. Conservative management of Achilles tendon pain may be unrewarding except in acute crepitating peritendinitis. Various forms of conservative treatment are discussed and the literature reviewed. The role of surgery in management of chronic resistent Achilles tendon pain is discussed in detail with particular reference to the indications and the surgical procedures available. The postoperative management of patients following Achilles tendon surgery is discussed and the outcome indicated.

Fifty patients suffering from sports injuries were included in a double-blind trial comparing the efficacy and side-effects of naproxen and indomethacin. The patients' daily record cards showed that the number of patients whose paine cleared in less than seven days was statistically significantly greater in the naproxen grout (P = 0.03). Overall change at the seven-day follow-up visit, changes in the degree of pain, swelling and limitation of movement, as well as the number of patients ready for full activity at seven days were also greater in the naproxen group. However, the differences between the two groups of treatment did not reach statistical significance. The number of side-effects was equal in both treatment groups. One patient on indomethacin had to be withdrawn from the trial after two days' treatment, because of severe gastric pains.

Thirty sportsmen and women with chronic sprain of the lateral ligament of the ankle characterized by instability and pathological talar tilt have been treated by plication of the anterolateral capsule with extensor digitorum brevis transfer and all have returned to normal sporting activity.