Achilles Tendinopathy

Back of heel pain

What is an achilles tendinopathy?

The achilles tendon attaches the calf muscles (at the back of the shin) to the heel and foot, and can be a common site for injury, particularly in active individuals. The achilles tendon transfers forces from the calf muscles to produce downwards movement of the foot (plantarflexion), and acts as a spring when performing movements such as repeated hopping or jumping.

Achilles tendinopathy is an umbrella term used to refer to any irritation of the achilles tendon, with or without inflammation. The most common causes of tendon irritation are:

  • A rapid increase in activity (overloading)
  • Internal compression of the tendon (pressure from another muscle or tendon)
  • External compression of the tendon (such as a tight heel on your shoe)

What does an achilles tendinopathy feel like?

If you have an achilles tendinopathy, you may have the following symptoms:

  • Pain in the tendon or back of heel
  • Stiffness in the tendon
  • Swelling at the back of the ankle and heel
  • Tenderness when touching the tendon 
  • Pain that improves as it warms up
  • Stiffness and pain that is worse in the morning or after rest
  • Pain with hopping
  • Pain with prolonged walking or standing

For some, the pain may be concentrated more in the tendon, or towards the back of the heel. Depending on the specific location of pain, you may have a mid-portion tendinopathy (pain in tendon), or an insertional tendinopathy (pain in heel). Treatment can differ slightly depending on which type of tendinopathy you have, so having a thorough assessment to determine the specific condition and rule out other diagnoses is important to ensure you receive the right care. 

What does treatment involve? 

Treatment for an achilles tendinopathy will involve loading the tendon progressively through exercise. This is done to improve the strength of the calf muscles and tendons, improve the health of the tendon tissue, and prepare you for your return to your desired activities. In some cases, your physiotherapist may also refer you to see our podiatrist to determine if your foot and ankle posture might be contributing to your pain.

Once your achilles pain has started to resolve, your physiotherapist and exercise physiologist will help you gradually reintroduce activities to prevent reaggravation. Before your return to sport, you will have progressed through your strength exercises and there will be a focus on high impact loading through jumping and landing.

Tendinopathies can take a long time to fully resolve, and ongoing management is of utmost importance to prevent recurrent issues. To help you self-manage your condition and prevent too-frequent visits to the physiotherapist, your clinician will help you devise a simple exercise routine that you can do independently.

If you are suffering from heel pain that sounds like an achilles tendinopathy, contact our friendly team at Solutions Allied Health on 1300 738 609 to book an appointment. 

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