Achilles Tendinopathy

Did You Know?

The Achilles is the largest and strongest tendon in the body.

What Is Achilles Tendonitis?

Achilles tendinopathy is a common injury among athletes and active individuals. The Achilles tendon is the largest tendon in the body, connecting the heel to the calf muscles. If it becomes inflamed or irritated, it can cause Achilles tendinopathy, also known as Achilles tendonitis. The condition causes pain and stiffness in the tendon, limiting mobility and making it difficult to perform physical activities.

Anatomy

The Achilles tendon is the largest and strongest tendon in the body, connecting the calf muscles to the heel bone. It plays an important role in the movement of the foot, enabling you to walk, run, jump, and climb stairs.

The tendon is prone to injuries, with Achilles tendinopathy being one of the most common. This condition occurs when the tendon becomes inflamed or damaged, leading to symptoms like heel pain, swelling, and stiffness.

The Achilles tendon is divided into two sections: the tendon itself and the paratenon, a thin sheath that surrounds the tendon. The tendon is composed of collagen fibres that are arranged in parallel bundles, giving it the strength and flexibility required for movement.

The blood supply to the Achilles tendon is limited, which makes it susceptible to injuries and slower to heal. This is why Achilles tendinopathy can be a challenging condition to treat and manage.

Symptoms

Achilles tendinopathy is a common injury that affects athletes and people who are active on their feet. One of the most noticeable symptoms of Achilles tendinopathy is heel pain, which usually develops gradually over time. Initially, the pain may only be felt after exercise or activity, but as the condition progresses, the pain may become more constant and intense.

Other symptoms of Achilles tendinopathy can include stiffness and swelling around the Achilles tendon. In some cases, there may also be a noticeable thickening or nodule in the tendon. People with Achilles tendinopathy may also experience limited range of motion in their ankle, as well as a sensation of weakness or instability.

What Causes Achilles Tendonitis?

Achilles tendinopathy can be caused by a variety of factors, including overuse, improper footwear, poor biomechanics, and certain medical conditions.

• As with many soft tissue injuries a sudden increase in activity levels can lead to a higher risk of injury in this tendon

• Footwear – certain footwear with a lower heel drop are often associated with an increased risk of Achilles tendonitis i.e. football boots, minimal footwear

• Age – Achilles tendonitis is more prevalent as you age

• Sex – more common in males

• Foot function – some foot type are more likely to increase load on the Achilles tendon

• Medications – some antibiotics have been associated with higher rates of Achilles tendonitis.

How To Treat Achilles Tendonitis

Like with most injuries that are many factors to consider when treating Achilles tendinopathy. My initial advice would be to book in one of our MSK podiatrists so that they can accurately diagnose and treat the condition. Common treatments include:

Orthotic Therapy
Orthoses can be designed to reduce load on the tendon when you are walking or exercising. This treatment is often used in combination with a strength and rehabilitation programme.

Strength and Rehabilitation
Strengthening the gastrocnemius and soleus muscles are often utilised when treating Achilles tendonitis. Eccentric and isometric exercises are often integrated within the programme as evidence suggests it is very effective when treating this condition.

Shockwave Therapy
Shockwave therapy can be used to stimulate recovery when dealing with this condition. This is often utilised when the condition has reached a chronic state (approx. 4 months).

Other treatments can include:

Steroid Injections
In my opinion due to this being an invasive procedure you should only consider steroid injections as a last option.