Achilles Tendon Pain
The achilles tendon is the large tendon at the back of the ankle that connects the calf muscle and the heel bone (calcaneum). It is responsible for moving the foot downward, pushing off when walking and running and standing on tip toes.
Irritation of this tendon can cause pain around the back of the ankle when walking, stair climbing or undertaking exercise. The condition most commonly affects the middle age group especially those who are in regular training.
Tendons are made of strong fibres of collagen that twist together to form a strong rope like structure. As you get older these fibres become weaker and less flexible making them more prone to microsopic tears. The blood supply to this part of the tendon being poor the tears often don’t heal properly resulting in ongoing pain and discomfort.
What are the symptoms?
The most common symptom of achilles tendonitis is pain and stiffness along the course of the Achilles tendon at the back of the ankle. This is particularly worse first thing in the morning when it has been rested for several hours and after activity.
As the condition progresses the tendon itself becomes thickened. This swelling causing the thickening can occur either in the middle of the tendon or at the bottom of the tendon where it inserts into the heel.
How is it diagnosed?
A diagnosis is most commonly made by history and examination. Sometimes your specialist may request x-rays of the heel bone to look for soft tissue swelling and any bony spurs on the heel bone. The most reliable form of imaging to confirm a diagnosis is an MRI scan which will demonstrate any swelling and tendon damage.
How is it treated?
Treatment options are both operative and non-operative.
- Non-operative treatment – this group is by far the most common treatment plan with the majority of people’s symptoms improving. The initial steps are a reduction in activity levels and regular painkillers and/or anti-inflammatories.
Physiotherapy consists of stretching of the tendon in a controlled fashion in conjunction with a silicone heel raise in your shoe. This helps to off-load the achilles tendon.
In some cases Extracorporeal Shockwave Therapy (ESWT) can help with reduction in swelling of the tendon and aims to promote healing within the tendon.
- Operative treatment – is only considered if all non-operative modalities have been exhausted. The surgery involves exploration of the tendon and debridement any inflamed or damaged tissue.
Important: this information given above is only a guideline as is not complete. For more information or to book an appointment please contact us.