Achilles Tendinopathy

Achilles Tendinopathy

Rachel Miller is a highly experienced podiatrist who treats many patients for Achilles tendinopathy.

A tendon is a tough fibre that attaches muscles to bone and your Achilles tendon is the biggest and strongest tendon in the body.  Your Achilles tendon is at the back of the lower leg above the heel bone and  it attaches your two calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).

Your muscles or tendons can become injured or inflamed as a result of overuse or trauma. Injuries to tendons often occur near joints and can result from small repetitive injuries over a period of time, or sudden acute injuries that occur if the tendon has been weakened.

Please see below if you want more detailed explanation of Achilles tendinopathy, its symptoms, causes and treatment.

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Symptoms of Achilles tendinopathy

A symptom can include:

• Pain usually at the back of your ankle or heel.
• A burning pain on the start of an activity, less during the activity and worse after the activity.
• Swelling at the back of your ankle.
• Tenderness.
• A creaking or crackling sound when you move your ankle.
• Pain can be worse at night or in the morning.
• There can be stiffness and a loss of strength.
• There can be tight calf muscles and a limited range of motion.

If there is inflammation there can be:

• redness
• warmth
• there can be a lump

An Achilles tendon can also tear, completely rupture, or sublux, partially dislocate.  If the pain is sever or sudden seek medical attention immediately as you may have torn your Achilles tendon.

Causes of Achilles tendinopathy

Achilles tendinopathy is sometimes described as an overuse injury, where the tendon has difficulty healing as it is damaged by repeated stresses and strains. It is common in athletes such as runners and jumpers who use repetitive actions in their sport.  The causes of Achilles tendinopathy are not completely understood but risk factors can include:

• changes to training regimes or intensity
• changes to surface an athlete is training or competing on
• incorrect footwear
• age; most common from the age of 30 onwards
• weight
• some medical conditions
• previous injuries can be an important factor
• foot structure can also be a factor
• tight calf muscles
• weak calf muscles

You may overpronate, where your foot rolls in during gait, or less commonly, supinate, where your foot rolls out during gait. These conditions can exert excess forces and stress on the joints and ligaments in the foot and ankle, potentially leading to injury.

Treatment of tendinopathy

There are different phases to Achilles tendinopathy and an early comprehensive diagnosis by an experienced podiatrist is important in deciding on what is the best treatment for managing your condition.

Treatments of tendinopathy include:

• tailored exercises and stretching regimes
• self-help advice
• footwear advice
• heel pads
• ice packs
• some medications
• rest
• orthotic insoles

You may benefit from a specialist biomechanical assessment. A bespoke orthotic insole can be prescribed as part of your treatment plan to support and cushion the foot, which may help reduce pain on impact when walking and running.

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