What is Achilles Tendonitis?

Tendonitis at the Achilles tendon is also known as tendinopathy. The Achilles tendon can be found at the back of the lower leg and joins the calf and heal. Tendonitis is caused by over use, basically doing too much too soon. It is estimated that Achilles tendonitis accounts for 11% of all running injuries.

Symptoms

Tendonitis is a regressive injury. The first phase of Tendinopathy is the acute stage, which is easily treatable and should mainly include rest. If the injury goes untreated, chronic tendonitis may occur and could lead to the rupture of the tendon.

·         Acute Tendonitis: Occurring over a period of a few weeks

• Gradual onset of pain over a period of days


• Pain at the onset of exercise which fades as the exercise progresses.


• Pain eases with rest.


• Tenderness on palpation.

·         Chronic Tendonitis: Appears over an extended period of time, usually due to lack of treatment

• Gradual onset of pain over a period of weeks, or even months.


• Pain with all exercise, which is constant throughout.


• Pain in the tendon when walking especially up hill or up stairs.


• Pain and stiffness in the Achilles tendon especially in the morning or after rest.


• There may be nodules or lumps in the achilles tendon, particularly 2-4cm above the heel.


• Tenderness on palpation.


• Swelling or thickening over the Achilles tendon.


• There may be redness over the skin.


• You can sometimes feel a creaking when you press your fingers into the tendon and move the ankle.

Causes

Although this injury is primarily caused by overuse of the tendon; hence why runners are affected, there are other factors that contribute to developing the condition.

·         Increase in activity (distance, intensity, speed, environmental change).

·         Reduced recovery time between workouts or exercises.

·         Weak calf muscles.

·         Decreased range of motion at the ankle joint, usually caused by tight calf muscles and fatigue.

·         Change of footwear or training surface.

·         Hill running – This ties into increased activity. Due to the Achilles having to stretch further for a longer period of time.

·         Biomechanical faults – A detrimental running style, like a rolling your foot over when running can cause increased stress on the tendon.

·         Wearing high heals on a regular basis shortens the tendon and calf muscles. When exercises you where flat or flatter trainers, this stretches the tendon beyond its shortened range, which places ‘abnormal’ strain on the tendon.

Anatomy

The Achilles tendon is a large tendinous extension of the two muscles at the back of the ankle. It connects the gastrocnemius and soleus (two large calf muscles) to the calcaneus (head bone).

 It is the thickest and strongest tendon in the human body and can receive a load stress of 7.7 times your own body weight when running. This is a process of evolution, allowing us to stand upright and run 80% faster. The Achilles tendon is shorter or absent in great apes.

Treatment

If Tendonitis is diagnosed early enough, then rest and cold therapy (ice) is sufficient treatment for full recovery. Once you have recovered from the injury, a rehabilitation course should be started, or the injury will return.

 If Tendonitis is untreated then the acute injury will become a chronic injury and in severe cases the tendon may rupture.

·         Rest and apply cold treatment (applying ice): This is where you ice the area for 15 – 20 minutes at a time. It is used with the world renowned R.I.C.E (Rest, Ice, Compression, and Elevation) technique. For best results try plunging the joint in ice water.

·         Change footwear and undertake a Gate Analysis. A Gate Analysis is where you have your running / walking pattern evaluated and then corrected.

·         Stretch to try and lengthen the tendon and calf muscles once the swelling and pain has reduced.

·         See a Physiotherapist or Sports Massage Therapist who can advise you on rehab and perform treatment.

·         If problem persists, see a doctor.