Achilles Tendon Disorders Explained

The Achilles tendon is a strong band of tissue connecting the calf muscle to the heel bone. It is the longest tendon in the body and runs down the back of the lower leg. Sometimes called the heel cord, this tendon plays a key role in walking by helping to raise the heel off the ground. 

Two common problems with this tendon are Achilles tendonitis and Achilles tendinosis. Achilles tendonitis means the tendon is inflamed. This inflammation usually lasts for a short time. If it persists, the tendon can start to break down. This condition is called Achilles tendinosis. The tendon loses its normal structure and can develop small tears. In some cases, the damage occurs at the point where the tendon attaches to the heel bone. In rare cases, the tendon tears completely, which is called a rupture. 

Symptoms 

Signs of Achilles tendon problems include: 

• Pain, stiffness, or soreness along the tendon. This pain can be above the heel or closer to the calf muscle. 

• Pain that is worse in the morning or after periods of rest may improve with movement but often returns or intensifies with increased activity. 

• Tenderness when squeezing the sides of the tendon. Pressing on the back of the tendon usually hurts less.  

• If the condition progresses, the tendon may become swollen and develop lumps in the areas where it is damaged. 

Causes 

These issues often develop as a result of overuse or repetitive strain on the tendon. This typically involves increasing activity levels too quickly without allowing enough time for rest and recovery. This overuse causes tiny injuries in tendon fibers. When the tendon is repeatedly overstressed, the body is unable to repair the tissue effectively. This leads to pain and damage. 

Athletes face a higher risk of developing Achilles tendon issues. Jobs that require prolonged standing or walking increase the risk of developing these conditions. Those who engage in intense physical activity infrequently may also be vulnerable. Additionally, flat feet or overpronation, when the foot rolls inward excessively, place extra stress on the tendon, and wearing unsupportive shoes can worsen the problem.

Treatment 

How the tendon is treated depends on how severe the injury is and how long it has lasted. 

Early on, when the tendon is inflamed, treatments may include: 

Rest and immobilization: A cast or walking boot can effectively protect the tendon and promote healing. 

Ice: Apply ice wrapped in a towel to the sore area for 20 minutes every hour. Do not put ice directly on the skin. 

Physical Therapy: Exercises to strengthen the calf, massage, stretching, and techniques to improve walking and running. 

Shoe inserts: These reduce stress on the tendon. 

Prevention 

To prevent the problem from recurring, daily calf strengthening exercises are recommended. Wearing appropriate shoes for your foot type and activities is equally important.