What is Achilles Tendinopathy?

You may have heard of different terms for Achilles Tendonitis. Achilles Tendonitis is Latin for ‘inflammation of the Achilles Tendon’. Tendinopathy refers to the disease of the tendon if the inflammation is not present.

Achilles Tendons are the longest tendons in the body, connecting the calf muscles to the heel bone. When the calf muscles contract, they pull on the Achilles Tendon, causing the foot to point down and helping you rise on your tiptoes.

It is one of the most common injuries in athletes, estimating to afflict up to 20% of all runners.
Achilles Pain occurs just above the back of the heel and often you will also experience tightness in the calf muscles. Pain is present with walking and running, especially when pushing off on the toes.

What causes it?

Achilles Tendonitis pain can develop gradually without any history of injury or trauma. The pain can be a burning pain, a shooting pain, or even an extremely piercing pain.
Achilles Tendonitis should not be left untreated because there’s a chance the tendon will become weak and ruptured.

Achilles pain can be aggravated by activities that repeatedly put stress on the tendon, causing irritation and inflammation.

The most common reported cause of Achilles Tendinopathy is repetitive load which exceeds the ability of the tendon. This can be caused by tight calf muscles, excessive pronation (flat feet) or limb length discrepancy (one leg longer than the other).

Other causes include long distance marathon running, where the tendon is constantly under extreme stress undertaking different terrains, hill running, running on uneven terrains and hard surfaces. This causes the tendon-muscle unit to change traction too quickly.Are your running shoes showing excessive wear patterns on the outer sole? Or the heel of the shoe distorted where you are landing unevenly ? Lower limb malalignments such as:

  • Tibial Varum (bowed legs)
  • Compensated Gastroc-soleus Equinus (limited flexibility in the calves)
  • Ankle Block Equinus (limited movement in the ankles)
  • Cavus Foot Type (high arched foot)
  • Hyperpronation (foot rolling inwards too much when the foot lands to the ground)

All theses conditions will be checked by your Podiatrist during a comprehensive Biomechanical Assessment.

During the assessment we will check the flexibility of hamstrings, quadriceps and calf muscles. Bring along your running shoes and shoes you wear most often to check for wearing patterns.

From our OptoGait system we will analyse and video your Gait (walking pattern) and show you how you can further improve your run to prevent problems occurring in the future and provide an individualised recovery plan.

Achilles pain is a common problem, and often experienced by athletes, particularly distance runners.

Achilles Tendinopathy is a difficult injury to treat in athletes due to their high level of activity and reluctance to stop or slow down their training.
Persistent strain on the Achilles Tendons causes irritation and inflammation. In severe cases this strain may even cause the tendon to rupture!

Chronic overuse (particularly in runners) may contribute to changes in the Achilles tendon as well, leading to degeneration and thickening of the tendon.

What will happen if I leave it untreated?

Achilles Tendonitis can develop into a chronic condition if left untreated. The risk of a tendon rupture is also increased. Movement can also become restricted if untreated and if you continue with the activity that has caused the injury.

What can help?

Rest, ice, exercises and NSAID’s such as ibuprofen can help to relieve the symptoms.
It is vital to stop the activity that has caused your Achilles pain as soon as it happens. This will prevent any further damage and will allow the tendon time to heal. Rest is aimportant part of the recovery process.

You can start to gently introduce activity as the pain decreases but if you feel pain you should stop immediately and rest. Applying ice to the painful area can help to reduce inflammation. Do not apply ice directly to the skin. Wrap in a towel and apply to the affected area for 10-20 minutes three times a day.

At Mespil Foot & Ankle Clinic we will correctly diagnose your condition and start you on a treatment a rehab programme which may include taping & strapping, soft tissue mobilisation, dry needling, manual stretching, orthotics, or a stretching and strengthening plan to take home with you.

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