What is the Achilles Tendon and Why is It Important?
The Achilles tendon is the thick, fibrous tissue that connects your calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It is the strongest and largest tendon in the human body, playing a vital role in walking, running, and jumping. Every time you push off the ground, whether walking or sprinting, the Achilles tendon absorbs and transfers tremendous force, allowing your foot to move efficiently.
This tendon enables plantarflexion, the movement where your foot points downward and is stretched during dorsiflexion, where your foot flexes upward. These actions are crucial for everything from basic mobility through to high-intensity sports. Without a properly functioning Achilles tendon, daily activities such as walking up stairs or standing on your tiptoes is incredibly challenging, which is why maintaining its health is essential for both athletes and non-athletes alike.
Unfortunately, the high level of stress placed on the Achilles tendon can make it prone to injury, which can result in Achilles tendon pain and even Achilles tendinopathy—an issue that can significantly limit your mobility and quality of life if not addressed properly.
What Causes Achilles Tendon Pain?
Achilles tendon pain is a common problem and can result from several factors. Understanding these causes can help in preventing the issue from escalating or recurring.
Overuse: The most common cause of Achilles tendon pain is overuse, particularly in athletes or individuals who frequently engage in activities like running or jumping. Over time, the repeated stress on the tendon can cause tiny tears and lead to inflammation, a condition known as Achilles tendinitis.
Sudden increase in physical activity: If you drastically ramp up your exercise regimen—whether by increasing the intensity, frequency, or duration of your workouts—your Achilles tendon may not have time to adapt to the increased load. This sudden stress can cause pain and inflammation.
Improper footwear: Wearing shoes that don’t offer adequate support, especially when exercising, can place extra strain on the Achilles tendon. Shoes with minimal cushioning, lack of arch support, or tight heels can exacerbate the issue. A sudden change from a traditional shoe with a heel pitch to “zero drop” or barefoot shoes can also cause Achilles tendon pain.
Foot biomechanics: Flat feet, high arches, or improper alignment in your foot structure can alter the distribution of forces across the foot. This altered foot function can increase tension in the Achilles tendon. Other movements such as excessive pronation (inward rolling of the foot) can put undue stress on the tendon.
Age and tendon degeneration: As we age, the Achilles tendon loses flexibility and becomes more prone to injury. This degeneration can progressively become worse and lead to Achilles tendinosis, a chronic condition in which the tendon weakens and becomes painful without inflammation.
Trauma or sudden injury: In some cases, Achilles tendon pain occurs due to a direct injury or trauma. For example, a sudden sharp movement or a strong impact on the back of the heel can result in an Achilles tendon rupture—a serious condition requiring immediate medical attention.
Recognising these causes can help you modify your activities or habits to avoid Achilles tendon pain and ensure the long-term health of your feet and ankles.
Symptoms of Achilles Tendon Pain You Shouldn’t Ignore
Early identification of Achilles tendon pain symptoms is critical in preventing more severe injuries. Many people brush off the initial signs of tendon issues as minor discomfort, but ignoring the pain can lead to more serious complications.
Some symptoms of Achilles tendon problems include:
- Stiffness and pain at the back of the heel: This is often worse in the morning or after long periods of inactivity. You may feel stiffness in the tendon, especially after waking up, which tends to loosen after some movement but returns later in the day.
- Swelling and tenderness: The back of your heel or lower calf may become swollen or feel warm to the touch. This swelling is often due to inflammation in the tendon.
- Thickening of the tendon: Chronic Achilles tendinosis can cause the tendon to become visibly thicker or develop a lump along its length.
- Difficulty walking or running: Pain during activities that involve pushing off your foot—like walking, running, or climbing stairs—is common with Achilles tendon injuries. You may notice a decrease in your ability to perform physical activities without discomfort.
- Pain when stretching or loading the tendon: Stretching and loading the Achilles tendon, such as when standing on your toes or stretching your calves, can become painful.
- A popping or snapping sound: In the case of an Achilles tendon rupture, you might hear a popping sound, followed by sharp, immediate pain at the back of your ankle or lower calf. A rupture is a serious injury that often makes walking impossible and requires urgent medical attention.
If you’re experiencing these symptoms, it's crucial not to delay seeking professional advice, especially if the pain persists or worsens over time.
When to See a Podiatrist for Achilles Tendon Pain
If you’re dealing with persistent or worsening Achilles tendon pain, it's important to consult a podiatrist. While some cases of tendon discomfort may resolve on their own with modified activity and calf massage, chronic pain or severe injuries should not be ignored. Seeking help from a podiatrist for Achilles tendon pain ensures a proper diagnosis and an appropriate treatment plan.
Here are some situations where seeing a podiatrist is necessary:
- Persistent pain lasting more than a week: If your tendon pain doesn't improve with rest or over-the-counter remedies, it may be a sign of a more serious problem.
- Difficulty walking or performing normal activities: If you find yourself limping or unable to perform your usual activities due to pain, a podiatrist should be consulted to assess the situation and provide treatment.
- Visible swelling or thickening of the tendon: This can indicate tendonitis, tendinosis, or even a partial tear, all of which require professional care.
- Sharp, sudden pain: Any acute injury accompanied by a popping sound or immediate difficulty walking could indicate an Achilles tendon rupture, a condition requiring urgent treatment.
Ignoring Achilles tendon pain can lead to chronic issues, long-term disability, or in severe cases, surgical intervention. A podiatrist can diagnose the underlying cause and create a customised treatment plan to alleviate the pain and promote healing.
How My Family Podiatry Treats Achilles Tendon Pain
At My Family Podiatry, we specialise in Achilles tendon pain treatment, offering a comprehensive approach that combines personalised care with advanced techniques. After a thorough assessment of your condition including in house diagnostic ultrasound to confirm the extent of injury, our team will design a treatment plan tailored to your specific needs.
Here are some of the treatment options we provide:
Activity modification: Reducing or modifying activities that exacerbate the pain is often the first step. This may include reducing the number of days or volume of training, changing the exercise (eg. treadmill running to a cross trainer) or finding another way to keep you moving without pain. We’ll guide you in adjusting your activity levels to prevent further strain on the tendon.
Physical therapy: Exercises to strengthen the calf muscles and improve flexibility in the Achilles tendon are a cornerstone of treatment. We’ll provide you with specific stretches and strengthening exercises that target the tendon, helping to rebuild its strength and elasticity.
Orthotics: Custom orthotics can address biomechanical issues that may be increasing the stress on your Achilles tendon. Our podiatrists will create orthotics tailored to your foot shape and movement patterns, offering better support and relieving pressure on the tendon.
Shockwave therapy: Extracorporeal shockwave therapy (ESWT) is a non-invasive treatment that uses high-energy waves to promote healing and reduce pain. It’s particularly effective for chronic cases of Achilles tendinosis, stimulating the body’s natural repair processes.
Anti-inflammatory treatments: For cases where inflammation is present, we may recommend non-steroidal anti-inflammatory drugs (NSAIDs) or other modalities to reduce swelling and pain.
Our goal is to not only relieve your Achilles tendon pain but also to help you regain full function and prevent future injuries. Whether through conservative management or more advanced interventions, our team is committed to providing you with the best care.
Conclusion
Achilles tendon pain is a common issue that can significantly impact your ability to move and enjoy daily activities. If you're experiencing symptoms or struggling with chronic pain, don’t wait to seek professional help. At My Family Podiatry, our experienced podiatrists are ready to diagnose, treat, and provide ongoing support for your recovery. Book an appointment today to get back on your feet, pain-free.
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