Achilles Tendon Pain
Achilles tendon pain is one of the most common tendon injuries and should be treated as early as possible.
The majority of Achilles tendon pain is of a slow onset, over-use nature – compared to a sudden acute tear or rupture of the tendon.
The Achilles is the insertional tendon of the Gastrocnemius and Soleal muscles (aka calf muscles) and is essential for everyday activities such as walking, running and jumping. Due to the tendons crucial role, it is subject to high repetitive stresses and in conjunction with certain risk factors, can eventually begin to degenerate or break-down.
This degeneration usually occurs in 2 locations; the insertion of the Achilles tendon onto the heel bone or mid-way through the tendon, hence the terms, insertional and mid-portion Achilles tendinopathy.
Signs and Symptoms
- Gradual onset without initial injury
- Initially pain may only be felt during exercise, as injury worsens pain may also be present during normal daily activities.
- Pain, tenderness and swelling around tendon
- Pain and stiffness most noticeable in the morning upon arising and after rest periods during day
- Weakness when jumping, hopping or skipping on affected leg
Why Did I get it?
Often achilles tendon pain occurs due to an increase in load placed on your lower limb that your body has not had the capacity to deal with.
This increase in load may be due to:
- Change in training intensity e.g. hill running, speed work, more jumping activities
- Inadequate rest between training sessions
- Change of exercise regime, or returning to exercise after pro-longed period of rest (too much too soon)
- Occupations/hobbies spending lots of time on your feet, especially hanging heel over ladders
- Wearing unsupportive or incorrect footwear or lots of barefoot walking
- Weight gain
Certain foot types increases the risk of developing achilles tendinopathy, such as:
- Rigid high arch foot
- Pronated/collapsed arch foot type
- Tight posterior chain (hamstrings and calf muscles)
- Restricted ankle joint or big toe joint dorsiflexion
How is it diagnosed?
A thorough clinical examination will most commonly diagnose Achilles Tendinopathy. Depending on severity of symptoms, you may be referred for an ultrasound to determine the extent of the degeneration and to make sure there aren’t any tears in the tendon.
- Footwear advice
- Moderated rest
- Eccentric Loading exercises
- Custom orthotics
- Heel raise in shoes
- Neuromuscular needling
Although Achilles tendinopathy is a debilitating condition, the majority of patients respond to conservative treatment. However, this process can take up to 9 months depending on how long the degeneration has been occurring for & how severe the pain has become.
Surgery is very rarely recommended, however is an option for chronic cases that show no improvement to conservative treatments.