What is the Achilles Tendon?
The Achilles tendon is a large tendon at the back of the ankle. The tendon is an extension of the gastrocnemius and soleus (calf muscles), running down the back of the leg, attaching to the calcaneus (heel bone). The Achilles tendon connects the leg muscles to the foot and gives the ability to push off during walking and running.
Did you know that the Achilles tendon is the thickest and strongest tendon in the human body? Its function is much like a spring.
What is Achilles tendinopathy, and what does it feel like?
Achilles tendinopathy is an overuse injury. The Achilles tendon is prone to injury when subjected to unaccustomed, repetitive high loads. It tends to occur as a reaction to an increased demand on the tendon, beyond its capabilities.
Runners for example, have a 15 times greater risk of Achilles tendon rupture and 30 times greater risk of tendinopathy as they age than do sedentary population. Because we spend alot of time on our feet, it can be difficult for the damaged and injured tissue to heal, which can lead to weakening of the tendon and in severe cases, rupture.
Achilles tendinopathy can present differently across many people, but commonly those with Achilles tendinopathy will typically report pain and stiffness, which may reduce in the short term with brief gentle movement. Other symptoms will include:
- Mild to severe pain and tenderness in the Achilles tendon area (tenderness may be more noticeable in the morning)
- Stiffness that may diminish as the tendon warms up with use
- Decreased strength and movement; a feeling of sluggish in the leg
Depending on the severity of pain, Achilles tendinopathy can be graded from 1-4
|1 (mild)||Pain after running only|
|2 (moderate)||Pain before and after running, pain gradually lessons during a run|
|3 (severe)||Pain with activity causing a decrease in volume of activity|
|4 (extreme)||Pain during everyday activities (pain worsening or progressing)|
Difference between mid-portion and insertional Achilles tendinopathy
Achilles tendinopathy can be described as insertional or midportional, the difference is the location. The insertional type is situated between the achilles and the bone, the midportion type is located at the level of the tendon body.
You are more likely to have an Achilles injury if any of the below apply to you:
- Previous lower limb tendinopathy
- Recent injuries
- Older population
- Decreased muscle power & strength
- Tight calf muscles
- Excessive foot pronation
- Recent changes in loading like returning after a long time away from particular activities or an injury
- Training errors – e.g. sudden changes in activity, changes in load, change of surface (e.g. hills), rapid increase in training, more frequent training etc.
Treating Achilles tendinopathy by yourself is very simple, but you have to be patient and strict with your regime. First and foremost, you must reduce the activities that irritate your tendon. If stress continues to be placed on the tissues, the tendon will become more and more irritated.
Substitute weight bearing sport activities for non-weight bearing activities such as swimming and cycling to maintain your fitness. Wear shoes that support the inner arch of your foot. Ensure you tie your laces securely.
Exercise is a critical component of any tendon intervention as it changes mechanical properties of the tendon, and increases the stiffness of the tendon that allows it to act efficiently like a spring.
(Do heel lifts on a step with straight knees (A), then progress to straight knees single heel lifts (B) and then progress to bent knees single heel lifts (C))
If pain continues to inhibit your activities, even after consistent self-treatment at home, it is probably time to seek professional advice from a health professional. Here at The Footcare Clinic, we offer a range of treatment options for achilles tendinopathy.
- Taping & strapping
- Biomechanical gait assessment or Running retraining/Rehabiliation
- Footwear assessment
- Shockwave therapy
- Strength & exercise programs
- Dry needling
- Professional advice for tendinopathy injuries.
With a bit of smart adjustment to your activity, and careful treatment of the problem, we’ll help get you back to moving well again.