Achilles Pain

Achilles Pain Overview

Achilles pain is amongst the most common lower body problems faced by podiatrists and doctors. Activities such as running and jumping create stress in the body and it is the duty of the largest tendon to hold it all, but if it is excessive and degeneration will be prone to develop tendonitis.

Achilles pain can generally be divided into sudden pain or  gradual onset of pain. Sudden pain is usually the result of the activity that caused the torn or ruptured tendon. Whilst this is not rare, gradual onset pain is more frequent. Injuries group known as tendinopathies  that most commonly cause pain that develops slowly and gradually getting worse. These are degenerative conditions of the tendon or the surrounding paratenon, also often known as tendonitis, although this suggests the presence of inflammatory cells which biopsies have not demonstrated.

Achilles Pain Causes

flat feet or over-pronation during walking or running which may cause achilles pain. Pronation is the opposite of supination. Our feet tend to turn in different ways when we are walking or running. If they are over-pronated, they turn too far inward. Shoes that properly stabilize your feet, custom-fitted orthotics, arch supports and insoles are some of the solutions. Heel cushions may help, too.

Should be made of medical grade silicon if you choose heel cushions. The point is to act as an extra shock absorber, reducing the impact on the joint when your foot slams down on a hard surface during exercise or just walking around. The cushions are among the least expensive treatment choices, available. Yet, many people find that they provide relief. Shoes that stabilize the fit and prevent over-pronation should include a "pronation control plate". You won't find the plate in the least expensive brands, but many of the "designer" running shoes don't have them, either. Just because it's a well known name does not necessarily mean that it is the best quality. You can visit a good shoe store or shop online for suggestions.

Pain in Achilles Symptoms

There are lots of symptoms of Achilles tendonitis, but the most common ones are stiffness and pain in tendon, particularly upon waking, ache in the heel or tendons that increases through weight-bearing activities, severe pain that occurs on the next day following physical activity. The growth of bone spurs as well as chronic swelling in the tendons which gets worse during physical actions or throughout the day. If you feel a sudden "popping" sensation at the back of your heel, it could be an indication that your Achilles tendon has been ruptured, and this situation needs instant medical attention.

Usually, until and unless the tendon is torn, Achilles pain isn't caused by any particular injury; instead it is a result of continuous stress that depletes the tissue's health. When suddenly there is an increase in the level of physical activity, excessive stress is being laid on the tendon, also a change in shoes or training surfaces like running uphill (training on an inclined surface), over-pronation of the feet, bone spurs and tight calf muscles are all responsible for developing an aching Achilles tendon.

Achilles Pain Treatment

Initially had a rest and cold therapy to relieve pain and encourage blood flow to treat Achilles pain in the form of tendinopathy. When ice is applied initially there is a decrease in blood flow, however when removed after 10-15 minutes there is a massive influx of blood to the area. This is important in Achilles injuries, as the tendon has a notoriously low blood flow which can make healing slow.

Other achilles treatment methods should include gentle stretching of the calf muscle complex, sports massage to the calf muscles and frictions to the tendon. Ultrasound or laser therapy may also be effective. Heel raises can be placed in the shoes on a temporary basis to help take the strain off the tendon. However, wearing these long-term can lead to shortening of the tendon. Once initial pain has decreased, an eccentric strengthening programme can be implemented. Eccentric exercises involve contracting the muscle whilst it lengthens (as opposed to concentric - where it shortens!). This type of exercise has been shown to be most effective in treating Achilles tendinopathies. The heel drop exercise is the gold standard here, performed on a step, starting on the tip toes and lowering the heels down slowly, under complete control until the heel is below the level of the step. As pain decreases, a gradual return to sport can be implemented, although to is important to ensure that any factors which may have contributed towards the development of the injury are corrected before returning. Common causative factors include tight or weak calf muscles, overpronation, sudden increases in activity, hill running and wearing high heels regularly.

You can read my other guide on Appendix Pain