The Achilles tendon is the largest tendon in the body which allows the extension of your foot in a downward motion as you walk. With every step, your Achilles tendon is working. However, if overused, the tendon is prone to Achilles tendonitis – the inflammation of the tendon. This inflammation can occur where it attaches to the heel bone or within the tendon itself.
There are two types of Achilles tendonitis:
- Non-insertional (affecting the middle portion of the tendon)
- Insertional (affecting the lower portion of the tendon, at the heel bone).
Who is most at risk?
Non-insertional Achilles tendonitis more commonly affects younger, active people. However, Insertional Achilles tendonitis can affect anyone at any time, even those who are not active. Although, those that were active over a long period of time (sprinters, long distant runners) and are no longer active are most at risk.
What causes Achilles tendonitis?
The most common cause is overuse and repetition. Runners, dancers, and athletes who do a lot of stop start exercise or jumping, put a lot of strain on the Achilles tendon.
However, there are other causes:
- tight calf muscles
- wearing ill-fitting running shoes
- excessive running up hill or down hill
- heel spurs
- a sudden increase in exercise, e.g. running for a longer distance
- wearing high heels often.
What are the symptoms of Achilles tendonitis
- Pain anywhere along the tendon, but most often on or close to the heel
- Swelling of the skin over the tendon
- Pain on rising up and pushing off on the toes
- Severe pain after exercising
- A painful heel in the morning
- A stiff ankle.
If you’re unable to stand on your toes or have experienced a sudden “pop” in the back of your calf or heel, you may have ruptured your Achilles tendon. Make sure you see your Podiatrist as soon as possible.
Rehabilitation for Achilles tendonitis
Your Podiatrist will create you a rehabilitation programme. This may involve the following:
- CAM Walker (moon boot) to immobilise your foot
- Low Level Laser Therapy
- Shockwave Therapy
- Dry Needling
- Exercises programme involving both stretching and strengthening of the Achilles tendon
- Orthotics may be prescribed
- Avoid activities that cause excessive loads on the Achilles tendon.
Preventing Achilles tendonitis
Achilles tendonitis is a debilitating injury, but there are ways to help prevent it.
- Do strengthening and stretching exercises
- Keep your hamstring muscles flexible
- Warm up and stretch before exercise
- Gradually increase exercise, never rapidly
- Do not continue an exercise if you experience pain over the tendon
- Wear properly fitted running shoes.