Overview

The achilles tendon is the thickest tendon in the body, connects the calf muscles to the heel bones and allows you to push your body up when walking or running. Achilles Tendinopathy is a condition that causes pain, swelling, stiffness and reduced strength of the achilles tendon.

This damage can occur over time or may happen suddenly due to a high force going through the tendon beyond what it can withstand. In some cases the tendon can rupture completely. Six in every 100 people will experience this condition at some stage of their lives, although it is most common in young people and athletes.

Causes

This condition is a result of the overuse of muscles that can lead to inflammation and microtears of the Achilles tendon. Over time, scar tissue can develop on the tendon that contributes to pain and stiffness.

The most common causes of this condition are:

  • Engaging in sports that require strenuous stop and start motions.
  • Running on uneven surfaces.
  • A sudden or dramatic increase in the intensity of physical exercise or activity.
  • Little or no warm up before exercise.
  • Abnormal foot mechanics.
  • Wearing shoes with poor heel or arch support.

Symptoms

A person with Achilles Tendinopathy may experience a burning pain in the affected area at the beginning of exercise that improves as exercise continues then returns afterwards. This is most common with runners.

A tender, red and inflamed lump may be present on the tendon and it may feel especially stiff in the morning and during the night. Severe pain that appears suddenly and causes difficulty walking may indicate a severe case of Achilles Tendinopathy, potentially involving a complete rupture of the achilles tendon.

Diagnosis

To determine if a patient’s pain is caused by Achilles Tendinopathy, a podiatrist examines symptoms and health history. The patient may be asked to stand and hop on one foot or to raise their heel off the ground to fully assess the capability and range of motion of the lower limbs. These observations will provide clues about possible damage to the tendon. In some cases it may be necessary to conduct an MRI or ultrasound to understand the severity of the injury.

Treatment

If treated correctly, Achilles Tendinopathy should not have any long-term effects. Dan Everson Podiatry recommends the following methods of treatment:

  • Rest your feet, although too much rest can slow recovery time.
  • Strap the affected area.
  • Apply ice to the affected area to reduce inflammation.
  • Use pain-relief medication.
  • Avoiding high impact activities.
  • Slowly return to physical activity or exercise routines as pain permits.
  • Perform achilles tendon exercises.
  • Invest in shoes that have great arch support and cushion the heel. 
  • Kinetic Orthotics may be prescribed to help treat this condition and prevent it from reoccurring.
  • Night splints to stretch your feet at night.

Prevention

Dan Everson Podiatry recommends the following activities to help prevent Achilles Tendinopathy:

  • When increasing your exercise and activity levels, do so gradually.
  • Walk and run on flat surfaces as much as possible.
  • Warm up – exercise at a slower pace and perform dynamic and static stretching before exercise.
  • Seek advice from a podiatrist on the most appropriate footwear or footwear modifications for your needs.
  • Strengthen your calf muscles with bodyweight and resistance training.
  • Stretch your feet and calves regularly.
  • Have regular foot massages.
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