Achilles tendinopathy describes changes to the tendon at the back of the heel and ankle. It is sometimes referred to as Achilles tendonitis and Achilles tendinosis, though technically these describe specific stages of the ‘damage’ process. The Achilles tendon attaches the calf muscles (at the back of the lower leg) to the back of the heel bone. If you touch the back of your ankle and feel a strong cord-like structure that moves as you point your foot up and down, that is your Achilles tendon.
What causes Achilles tendinopathy?
Anytime you walk, run, or even point your foot downwards, your calf muscle is actively working, and taking on tension. When this tension and strain exceeds what the tendon can safely handle (which varies from person to person based on strength, fitness, flexibility and many other factors), changes to the tendon can occur. These changes can result in pain, inflammation and degeneration.
The extent of the changes can range from micro-tears in the tendon, to partial tears, to complete ruptures. Any activity that overloads or places repetitive high loads on the tendon can result in changes to the structure of the tendon. These activities may include:
- Running activities, especially at high speeds or longer distances
- Changing the intensity of your training in sports or at the gym
- Repetitively overloading the tendon over time
- Having tight calf muscles that place greater compressive forces on the tendon
- Wearing unsupportive footwear, especially if it has low-set heels
- Poor foot biomechanics
What are the symptoms of Achilles tendinopathy?
If you are experiencing pain and swelling at the Achilles tendon at the back of the heel, it is likely that you have sustained changes to the Achilles tendon – although other conditions can cause similar symptoms which is why it is important to see a health professional for a full assessment.
The language around Achilles problems can be confusing:
- Tendonitis – describes inflammation occurring in the tendon and can result in pain and stiffness. Tendonitis is often seen in early Achilles injuries or can occur during a flare of an older injury.
- Tendinosis – describes micro-changes in the tendon with no significant inflammation. Often, an Achilles tendon injury starts with some inflammation (tendonitis). As the swelling settles, the injury progresses to a more degenerative state without any inflammation.
Don’t worry – regardless of your symptoms and whether any inflammation is present, your My FootDr Podiatrist will use evidence-informed treatment methods to help your recovery.
How we help with Achilles tendinopathy
Many factors can influence the strain and compression forces on your Achilles tendon including your age, your foot biomechanics, your footwear, muscle tightness and strength etc. It is important to fully assess the biomechanical function of your lower limbs when treating this condition. This way, we can help not only manage your current symptoms, but also help reduce the likelihood of the problem occurring again in the future.
Following a comprehensive assessment, we will work with you to help develop an appropriate treatment plan based on your results and your specific goals. Based on the most up to date evidence, it is very likely that your program will include specific exercises aimed an improving the load-capacity of the tendon. However, other treatment strategies may include: