Achilles

What is the Achilles tendon?

The Achilles tendon is the thickest, strongest tendon in the human body, & is the combined tendon of the calf muscles (gastrocnemius & soleus muscles). Its function is to transmit the force of the calf muscles to produce the push-off during walking & running.

What can cause pain in the Achilles Tendon?

Like any tendon injury, injury to the Achilles Tendon usually occurs when the load applied to the tendon exceeds the ability of the tendon to withstand the load. This can happen in a single episode, (i.e. rupture of the tendon) or over a period of time (i.e tendinopathy/overuse injury).

Achilles Tendinopathy is an overload injury that may come on gradually. You may have heard the condition called Achilles tendonitis in the past (-itis indicating inflammation), however studies have found that these painful tendons often show no signs of inflammation, but more signs of degeneration (like abnormal collagen fiber structure & a poor healing response), & so the umbrella term ‘Tendinopathies’ is now used.

There are numerous factors that may contribute to the development of Achilles tendinopathy. They include an increase in activity level or decrease in recovery time, change of surface, change of or poor footwear, excessive pronation (‘rolling in’ of the foot), calf weakness, poor calf flexibility, ankle stiffness, types of cholesterol & even a high waist girth measurement.

Symptoms

Symptoms of Achilles Tendinopathy include:

–       Swelling, mild/severe pain & tenderness between the heel & the calf muscle

–       Pain/stiffness first thing in the morning

–       Pain that is worse with activity (especially running & jumping)

Treatment

Physiotherapy treatment will usually include techniques to improve ankle mobility, specific strengthening exercises for the calf & Achilles, changes to footwear & changes to sport technique if needed. It may also involve referral to a Podiatrist for orthotics if thought necessary.

Achilles tendinopathies can take between 3-6 months to resolve, with problems at the tendon’s insertion to the heel taking longer than problems in the body of the tendon. They will always respond best if treated early – the longer they have been present for without treatment, the longer they generally take to get better. So, even if you’ve just started noticing a bit of Achilles stiffness first thing in the morning – come & get it checked out early!