Achilles Pain

Achilles tendinopathy/tendinitis

Achilles tendonitis (also known as Achilles tendinopathy or Achilles tendinosis) is an overuse injury causing pain, inflammation, and or degeneration of the Achilles tendon at the back of the ankle. Symptoms of acute Achilles tendonitis include:

• Gradual onset of pain at the back of the ankle, which may develop over a period of days.
• The Achilles tendon may be painful and stiff at the start of exercise and first thing in the morning.
• Pain often eases off as your tendon warms up, only for it to return later in the day or towards the end of a prolonged training session.
• The tendon will be very tender when squeezing it from the sides and there may be a nodule or lump felt in the middle of the Achilles tendon.

Achilles tenosynovitis

Achilles tenosynovitis (also called paratenonitis) is an inflammatory condition of the sheath or layer surrounding the Achilles tendon.

• Symptoms are virtually identical to those of Achilles tendonitis. It is practically impossible to differentiate between the two without MRI or ultrasound scans.
• In a large number of cases, both conditions exist together.
• The Achilles tendon will be painful to touch.
• Pushing up onto tiptoes or stretching the calf muscles may be painful and the tendon may appear swollen or thickened.

Sever’s Disease

This largely affects children aged 8-15 years old, especially during a growth spurt, or if they do a lot of sport.

• Pain and tenderness at the back of the heel which gets worse with exercise is the main symptom of this injury.
• A lump ior swelling at the back of the heel.
• Squeezing the sides of the back of the heel will feel particularly tender.

Insertional Achilles Tendonitis

Insertional Achilles Tendonitis occurs at the back of the heel where the Achilles tendon inserts into the heel bone. The injury is similar to Sever’s disease in children but affects adults. Symptoms of:

• Pain and inflammation at the back of the heel.
• Symptoms get worse with exercise.
• Sometimes you may see a lump at the back of the heel, where the Achilles tendon inserts into the calcaneus (heel bone).

Achilles bursitis

Achilles bursitis, also known as Retrocalcaneal bursitis is common in athletes, particularly runners. Bursitis is inflammation and swelling of a small sack of fluid, called a bursa.

• The bursa becomes inflamed, normally from overuse.
• You will have pain, swelling, and tenderness at the back of your heel.

Traditional Treatment for a Achilles Pain

Treatment for most achilles pain consists of two parts. The first priority is to treat the symptoms, reduce pain and inflammation in order to allow normal movement. The second aspect is to address the underlying causes and correct and correct them.

Rest – from activities which cause pain. The more you use the lower leg the longer it will take to heal and it may become chronic. Maintain fitness doing other activities such as swimming or upper body exercises. Avoid any achilles tendon exercises or weight training and in particular, avoid the activities which caused the injury in the first place.

Apply ice or cold therapy to reduce pain and inflammation. Ice can be applied every hour for 10 minutes initially reducing to 15 minutes every 3-4 hours as required to reduce pain and inflammation.

Medication – a doctor may prescribe anti-inflammatory medication such as ibuprofen which may help in the early stages but less so long term. Ibuprofen should not be taken if you have asthma and your doctor will always check for contraindications before prescribing medication.

Physical Therapy– a good therapist will help determine the cause of the injury whether that be a poor technique or work-related repetitive overuse and identify strategies or changes to avoid the injury recurring. In particular poor posture and muscle imbalances can be corrected with exercises, taping and workspace evaluation.

Boot– A boot can be worn to completely rest the Achilles tendon.

If these treatments fail to improve your pain, surgery may be recommended.