Achilles Tendinopathy Symptoms & Treatment

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What is Achilles Tendinopathy?

Achilles tendinopathy is a condition characterised by painful and damaging changes in the thick tendon at the back of the heel and ankle. This tendon, which connects the calf muscles to the heel bone, plays a crucial role in almost all movements, such as walking, running, and jumping. Often confused with Achilles tendonitis or tendinosis, these terms refer to different stages of tendon damage.
 
Tendonitis involves inflammation in the tendon, while tendinosis refers to the long-term degeneration of the tendon fibers without inflammation. Understanding these differences is essential for an accurate diagnosis, as treatment approaches vary depending on the stage and severity of the condition.
Pain in the right achilles tendon, displaying the area of pain that would hurt when someone has achilles tendinopathy

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What Causes Achilles Tendinopathy?

Each time you walk, run, or point your foot downward, your calf muscle is engaged, placing stress on the Achilles tendon. When this stress surpasses what the tendon can handle due to factors like strength, fitness, and flexibility it can lead to changes in the tendon, resulting in pain, inflammation, or degeneration.

These changes can vary from small micro-tears to partial or even complete tendon ruptures. Activities that can overload the tendon and increase stress include:

  • Running, especially at high speeds or over long distances
  • Intense physical activity or gym training
  • Repeated strain on the tendon over time
  • Tight calf muscles, which put added pressure on the tendon
  • Wearing unsupportive footwear, particularly with low heels
  • Poor foot biomechanics that place uneven stress on the tendon

What Are The Symptoms Of Achilles Tendinopathy?

If you’re experiencing pain and swelling in the Achilles tendon at the back of your heel, it’s likely that the tendon has been damaged. However, similar symptoms can be caused by other conditions, so it’s important to see a healthcare professional for a thorough assessment.

The terminology surrounding Achilles tendon issues can be unclear:

  • Tendonitis refers to inflammation in the tendon, which can cause pain and stiffness. This is commonly seen in the early stages of an Achilles injury or during flare-ups of an existing injury.

  • Tendinosis involves micro-changes in the tendon without significant inflammation. Achilles injuries may begin with inflammation (tendonitis), but as the swelling reduces, the injury often transitions into a more degenerative state without inflammation.

No matter what stage you’re experiencing, your podiatrist will use evidence-based treatment methods to support your recovery.

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How To Treat Achilles Tendinopathy

Since various factors can contribute to Achilles tendon strain—such as age, foot biomechanics, footwear, muscle tightness, and strength—we begin by evaluating the biomechanical function of your feet and legs. This allows us to not only address your current symptoms but also reduce the likelihood of future issues.

After a comprehensive assessment, we will work with you to develop a tailored treatment plan that aligns with your specific needs and goals. Based on the latest research, your plan will likely include targeted exercises to enhance the tendon’s ability to handle load. Additional treatment options may include:

  • Strapping
  • Footwear modifications
  • Custom foot orthotics prescribed by your podiatrist

Achilles Tendinopathy FAQ's

Achilles tendinopathy causes pain, swelling, and stiffness in the back of the heel or lower calf. You might notice the area becoming swollen, thickened, or a bump forming on the heel. Pay attention if the pain gets worse after walking, running, or standing for a long time. If you notice these signs, it’s important to see your podiatrist for the right treatment.

The healing time for Achilles tendinopathy depends on the severity of the injury, ranging from a minor strain to a more extensive injury or tendon tear. Recovery can take anywhere from a few weeks to several months. Your podiatrist will guide you through the best treatment plan to help you heal as quickly as possible.

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