What Is Achilles Tendinopathy?
Achilles tendinopathy is a prevalent condition that affects both athletes and non-athletes alike. At The Physios in Sheffield, we often see patients struggling with this painful and sometimes debilitating issue. Let’s explore what Achilles tendinopathy is, its causes, symptoms, and how we approach treatment.
What Is The Achilles Tendon?
The Achilles is one of the thickest tendons in your body. It connects the superficial calf muscles (mainly your big gastrocnemius and soleus muscles) to the heel bone (calcaneus). This allows you to walk, run and jump – essentially acting like a big spring.
Research shows that the Achilles tendon and deep calf muscles can absorb up to eight times your own body weight in force during running. This makes it exceptionally resilient and strong, unlike its Greek-derived name would suggest.
What Is Achilles Tendinopathy?
As used in many medical terms, ‘itis‘ is latin for inflammation. So Achilles tendinitis basically means inflammation of the tendon. Commonly there are two points on the Achilles tendon that are prone to becoming sore. Classically the mid-tendon (approx 4cm up from the insertion in the heel bone), and also the point of insertion itself, which can be more irritable and therefore take longer to heal. Both occur due to overuse.
What’s going on?
In recent years, it has been identified that Achilles tendinopathy is a more appropriate label for this condition. ‘Opathy’ being latin for ‘disorder of’, is used in recognition of the fact that the condition is most commonly chronic and degenerative in nature, rather than acute and inflammatory (which ‘itis’ would imply).
Tendons (and in general all soft tissues) are in a constant continuum of healing. When a tendon becomes painful in the first 3-6 weeks, be it a first time episode or a flare up of a persistent problem, we class this as the ‘reactive phase’. This is typically when symptoms are more acute and irritable. For example when walking with every step or going up and down stairs.
Over time the inflammation becomes more degenerative in nature due to a build up of scar tissue. This is termed as a ‘disrepair’ of the natural healing process. Achilles tendinopathy symptoms in this phase include:
- pain and/or stiffness that is worse on the first few steps in the morning
- pain and/or stiffness after walking after a prolonged period of rest such as sitting
- pain when running (classically at the start then eases until longer distances)
- pain on long walks or hikes
One simple way to establish what stage of healing the Achilles tendon is in and provide diagnosis confirmation is to use ultrasound imaging. Take a look here for more information on our specialist diagnostic ultrasound service.
Achilles tendinopathy | Common causes & risk factors
- Overload and repetitive strain (essentially sudden changes in activity)
- Flat feet
- Obesity
- Unsupportive footwear (e.g. high heels/sandals)
- Prolonged steroid use
- Hypertension (high blood pressure)
- Type 2 Diabetes
If you suspect you have an Achilles problem, you are likely to find our next blog on the best treatment for Achilles tendinopathy helpful.
If you have any questions regarding plantar fasciitis or any other injury, you can book an appointment online here or call our friendly reception team on 0114 267 8181.
