Achilles tendinopathy
What is it?
The Achilles tendon connects your calf muscle to the bone in the heel of your foot. Achilles tendinopathy occurs when small tears form in the fibres that make up the tendon. It's also sometimes referred to as Achilles tendonitis.
Symptoms
The main symptom is pain just above your heel bone that develops gradually. At first you may only have pain first thing in the morning or after exercise. The pain may disappear as you warm up, only to return when you cool down.
Over time, as the problem worsens, you may have pain for longer periods of time and you may eventually start limping. Your calf and the area above your heel may also be slightly swollen and feel stiff.
Causes
Achilles tendinopathy is usually caused by overuse and is a common injury in sports that involve running and jumping. Repeated stress on the tendon causes microscopic damage to occur.
Achilles tendinopathy is more likely to happen if you:
- increase your activity levels (mileage, speed, type of activity), for example hill training
- don't leave enough recovery time between training sessions
- change you usual training surface
- wear inappropriate footwear
- have poor movement (biomechanics) in your feet, for example flat feet
- have poor movement (biomechanics ) in your lower leg, for example poor calf flexibility
- have a poor range of movement in your ankle
Treatment
Achilles tendinopathy usually requires treatment. It's important to see a sports medicine professional, such as a physiotherapist or sports medicine doctor, to diagnose the problem and give you appropriate treatment.
A stretching programme is essential in treating Achilles tendinopathy. Treatment may also include massage, strengthening exercises and correction of poor biomechanics using orthotics (special insoles that you wear in your shoes).
Do
- Rest your injured leg but make sure you stretch your calf muscles
- Apply ice to the painful area until the swelling goes down. Don't put ice directly on your skin as it can give you an 'ice burn' - place a cloth between the ice and your skin.
Don't
- Ignore the pain. It may settle initially as the area warms up during exercise, but this can lead to further damage and make your injury worse.
Peer reviewed by David Toy, MCSP, Bupa Sports Medicine physiotherapist
Publication date: June 2009
