Achilles tendinopathy Mamae iohere punga
Your Achilles tendon attaches your calf muscle to your heel. Achilles tendinopathy is a condition that causes pain, swelling and stiffness in this tendon. It is common in people who play sports that involve jumping and running.
Causes of Achilles tendinopathy
While the cause is not certain, it may be due to repeated tiny injuries to the tendon.
Things that can lead to Achilles tendinopathy include:
- overuse
- wearing the wrong shoes when training or walking
- having a poor running technique
- rapidly increasing the intensity of your training and how often you train
- training or exercising on hard or sloped surfaces
- having ruptured or damaged your Achilles tendon in the past
- being older — your Achilles tendon weakens with age and tendinopathy is more common
- taking medicines such as steroids or certain antibiotics (fluoroquinolones)
- having a long-term medical condition such as diabetes, psoriasis, or rheumatoid arthritis
- being an unhealthy weight
- sudden accidental movements such as stepping in a pothole.
You may also be at higher risk for Achilles tendinitis because of your body shape and structure. For example, if you have:
- bone spurs (an extra bone growth in your heel that rubs the tendon) causing pain
- flat arches
- ankles that roll down and in when you walk (overpronation).
Symptoms of Achilles tendinopathy
Pain and stiffness in the tendon are the main symptoms. These may be worse when you first get up and improve once you are moving around.
The pain can vary. While you may feel pain during exercise, it is usually worse once you stop. Runners can notice pain when they start running. It then tends to become more bearable during the run. But it gets worse once they stop.
You may also notice pain when you touch the area around your Achilles tendon, and it may be swollen.
If you get a sudden, severe pain in the back of your leg and have difficulty walking, you may have torn (ruptured) your Achilles tendon. Some people say the pain feels like being hit in the leg, or they hear a snap or crack. See a healthcare provider urgently.
Diagnosing Achilles tendinopathy
Your healthcare provider, podiatrist or physiotherapist will usually diagnose Achilles tendinopathy by:
- listening to your symptoms
- examining your leg, ankle and foot.
If the diagnosis is unclear, they may suggest an ultrasound or MRI scan to see if you have any tears in your Achilles tendon.
Self care for Achilles tendinopathy
There are things you can do to help you manage Achilles tendinopathy.
Initially you may need to modify your activities to help your symptoms settle. This means limiting exercise such as running or high-impact sport that makes your pain feel worse.
Follow the advice on managing soft tissue injuries.
Soft tissue injuries and treatment
Simple pain relief, such as paracetamol, may help to make you more comfortable.
Pain relief medicine for adults
As your symptoms improve you can gradually increase your activity levels.
It is important that you do not stretch your Achilles tendon. Instead, you will need to start to gently and gradually strengthen it. One exercise to start with is a heel raise. In standing, rise onto your tip toes. You can hold this position for 5 seconds and slowly lower back down. It is important that you feel the tendon working but it should not be painful or stay sore afterwards
Symptoms should settle within a few weeks and completely go away within 6 months.
Treating Achilles tendinopathy
If you have not started to improve within 10 to 14 days, it is best to see a physiotherapist, podiatrist or other healthcare provider. They can help with your recovery. Treatment may include:
- specific exercises to strengthen your tendon
- modifying your activity levels
- advice and specific rehabilitation to help you return to sport
- assessment of your feet and legs, including how you walk and run
- advice about footwear and modifications such as orthotics or heel lifts for your shoes.
Steroid injections are not used for Achilles tendinopathy.