The Achilles tendon is a large tendon at the back of the ankle and is the strongest tendon in the body. Due to its strength the tendon allows us to point our toes and foot up and down. Likewise its strength allows us to stand up on our toes. The tendon also helps to propel the body forward in walking and running. Finally the tendon is also used a lot in jumping.
Achilles tendonitis is the term used when there is inflammation of the tendon, however Achilles tendinosis is degeneration of the collagen in the tendon
Tendinosis develops as the tendon is unable to maintain repair that keeps up because of the demands placed on it in “overuse injuries”
What are the causes?
There are many different causes of tendinosis and tendonitis, for example
- Sudden changes in activity levels, such as excessive jumping etc
- Inadequate stretching
- Training errors or ridged training surfaces
- Mechanical alignment problems in the foot and leg
- Poor shoes
- Certain diseases (ie Reiter’s disease)
- Taking certain medications can also affect the tendon (fluroquinolones)
What are the symptoms
There may be different presentations in different people but most commonly the person will feel
- Pain in the heel and along the tendon especially when walking, running or jumping.
- The area may feel painful and stiff in the morning.
- The tendon may be painful to touch or move.
- The area may be swollen and warm.
- You may have trouble standing up on one toe
What to do
If you suspect you have a problem in this area you really need to See your Osteopath or physiotherapist in order to have a proper examination and diagnosis of the pain.
Your Osteopath or Physio will probably apply gentle techniques to muscles in the leg that are associated with the Achilles tendon to ensure they are not too tight. They will give you instructions on how to reduce the load on the tendon – can be done with a heel lift or orthotics and activity modification.
Your Osteopath or physio will help to identify the cause of this episode of pain and prescribe you specific exercises and or stretches to avoid reoccurrence of the problem. They may suggest changes to your training if this has been the cause
Finally you can take measures to reduce inflammation. Using ice or anti-inflammatories which should only be taken under direction and supervision of a healthcare professional may be helpful.
What not to do
There are some things that can certainly be unhelpful or potentially make your problem worse. If you have an Achillies tendonitis do not apply heat to the region. We do not advise that you self prescribed exercises or stretches as these may irritate the problem. Finally we don’t recommend that you apply direct pressure or massage yourself.