If you have been suffering from heel pain when walking, running or jumping, it may be a sign of Achilles tendinopathy, a common injury of the Achilles tendon.
Achilles Tendinopathy is a common injury to the Achilles tendon, generally caused by repetitive overuse of the tendon, or trauma. It is characterised by pain, stiffness, and swelling of the tendon, as well as reduced ankle mobility and a negative impact on day-to-day life. Read on to find out more about what Achilles tendinopathy is, how it is treated, and how to prevent it.
What is Achilles Tendinopathy?
Achilles tendinopathy is a common injury that affects the tendon connecting your calf muscle to the heel bone. It is characterized by pain, stiffness and swelling to the tendon which limits your capacity for movement, especially when walking, going up or downstairs, and running.
Types of Achilles Tendinopathy
The pain related to Achilles tendinopathy can present itself anywhere in the tendon. Depending on where the pain is localised, this injury is characterised in two types:
Insertional Achilles tendinopathy – this causes pain at the point where the tendon meets the heel bone.
Mid-portion tendinopathy – this causes pain just above the heel or on other points of the tendon leading up to the calf muscle.
About The Achilles Tendon
Tendons are connective tissues that anchor muscles to bones. The Achilles tendon is the biggest and strongest tendon in the human body, ranging from 3.4-6.8cm wide. It attaches the soleus and calf muscle to the heel bone to allow us to lift our heels off the ground and control the position of the ankle, which is essential for a number of common movements including walking, running, jumping, climbing stairs, tiptoeing and believe it or not, sleeping. The resting position of our feet in bed has a huge impact on those suffering from Achilles tendinopathy
What causes Achilles Tendinopathy?
Achilles tendinopathy can generally be explained by an imbalance between the demand placed on the tendon and its ability to function. Injury is most commonly caused by repeated or prolonged irritation of the tendon, also known as microtrauma, that is not given the time to heal completely. Achilles tendinopathy happens as damage to the tendon builds up over time. Less commonly, Achilles tendinopathy can also happen as a result of a single acute injury to the tendon such as a kick to the heel or other sudden impact to the calf or heel.
Some of the common causes of microtrauma to the tendon are:
- Overuse of the tendon. Most commonly present in runners and those involved in sports that involve jumping, such as athletics, squash, tennis and basketball.
- Foot and Muscle Structure. In the case of flat or over-pronated feet, the tendon is put under constant stress which, in time, can lead to excessive irritation and inflammation. Excessively tight or weak calf muscles can also cause additional stress to be placed on the Achilles tendon.
- Footwear. Wearing the wrong footwear while exercising can contribute to additional mechanical stress on the tendon that over time will lead to injury.
- Poor Form. Poor running and exercise techniques can put additional strain on your Achilles tendon, leading to micro-trauma that over time can lead to serious injury.
- Health conditions. Achilles tendinopathy can be a symptom of other health conditions such as inflammatory arthritis, high blood pressure, cholesterol, diabetes, and the use of quinolone antibiotics.
Symptoms of Achilles Tendinopathy
Symptoms of Achilles tendinopathy are usually localised in the tendon area. They include:
- Stiffness and pain. Often present in the morning and at the beginning of a walk or run. Pain tends to ease during light exercise only to come back stronger once you stop moving.
- Tenderness and swelling. This can usually be noticed on the heel and into the tendon when manual pressure is applied.
These symptoms can present themselves in different intensities ranging from mild pain during or after exercising, to severe pain caused by a majority of weight-bearing movements, which stop you from carrying out everyday tasks.
It is important to note that sudden, severe pain in the tendon may indicate a rupture. If this is the case, please consult a medical professional immediately.
How is Achilles Tendinopathy Diagnosed?
In order to diagnose Achilles tendinopathy, your doctor or physiotherapist will carry out a physical examination of your heel, ankle, and calf as well as assess the movement, strength, flexibility and posture of the affected foot. They may also review your posture, medical history, exercise habits, and footwear to identify possible underlying causes of the injury.
Can Achilles Tendinopathy be Cured?
There are several approaches to treating Achilles tendinopathy. A Physiotherapist or musculoskeletal therapist is best equipped to help you deal with and overcome the symptoms of Achilles tendinopathy.
Once symptoms start to develop they must be addressed immediately, as continuing to exercise on an injured tendon will make the injury worse and lengthen the recovery period.
Achilles Tendinopathy Treatment
Treatment for Achilles tendinopathy aims to reduce or eliminate the source of strain on the tendon, prevent further injury and repair existing damage. Common approaches to treatment involve:
Relative rest
Once symptoms of injury start to develop it is extremely important to take time off high-impact activities in order to allow the tendon to repair itself. Achilles tendinopathy usually responds well to this approach, and you should be able to gradually return to your normal exercise routine as pain eases. However, if your symptoms are recurring, persistent, or if your pain is severe, it is important to seek professional help as soon as possible.
Pain control
Applying ice to the painful area for a maximum of 20 minutes, 4 to 6 times a day can help reduce pain and inflammation.
Simple anti-inflammatory painkillers such as ibuprofen or paracetamol can also help to deal with the pain associated with tendinopathy in the short term. However, they should be used in conjunction with relative rest and reduced-intensity exercise, as they can mask pain during exercise and aggravate the injury in the long term as you may not be aware of an increase in pain levels when further irritation to the tendon occurs.
Physiotherapy
If your symptoms do not improve within a week you should consider working with a physiotherapist or musculoskeletal therapist, who will be able to help you fully recover from your symptoms by using a combination of approaches, including:
- Manual Therapy. Using hands-on treatment to manipulate the joints and muscles to improve their function and in turn reduce pain.
- Isometric & Isotonic Exercises. Your physiotherapist can recommend a tailored exercise program aimed at reducing pain, speeding up recovery and strengthening the injured area.
- Non-invasive Treatment. Your physiotherapist will be able to recommend alternative non-surgical forms of treatment that complement your treatment and recovery process, such as shockwave therapy and/or dry needling.
How Long Does Achilles Tendinopathy Last?
The symptoms of Achilles tendinopathy can last anywhere from weeks to months and, in some cases, symptoms can recur chronically. However, the majority of cases see considerable pain and movement improvement after 8 to 12 weeks.
As a rule of thumb, the sooner Achilles tendinopathy is diagnosed and treated, the more likely it is to heal quickly.
Achilles Tendinopathy Prevention
As we have seen above, while some of the causes of Achilles tendinopathy can be related to underlying health conditions, this type of injury is often caused by controllable circumstances. As such, in order to reduce your risk of developing Achilles tendinopathy, you can:
- Prioritise rest if you start to experience tendon pain, as ignoring it will only make the condition worse
- Maintain proper form during exercise and integrate a variety of movements in your routine to avoid dramatic increases in intensity
- Wear supportive footwear that is appropriate for the type of exercise you are doing
- Incorporate stretching into your routine
- Maintain proper lower body strength
Physio & Therapy Services in Hexham
Physio & Therapy offers a number of services in our private clinic in Hexham to help you move better, feel better, and live better. Our experienced team comprises dedicated physiotherapists, sports therapists, clinicians, osteopaths and holistic practitioners who will work with you to identify the source of your pain and address it holistically, ensuring pain relief beyond the treatment room.
If you are suffering from Achilles tendinopathy or any other painful conditions, get in touch today and one of our team members will assist you in finding the best route to treatment and ultimately a pain-free life.