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Achilles Tendinopathy

The achilles tendon is the strongest and thickest tendon in the body. It is located below the calf muscle, and is responsible for connecting the calf muscles to the heel bone of the foot. It’s main function is to raise the heel when walking and running, and as such undergoes significant strain as it attempts to assist in helping the foot to “toe off” with each step.

Traction ApophysitisAchilles tendinopathy has a number of different presentations. It can come on quickly, or it can be a pain that has increased slowly over time. Activity can flare it up mildly or extremely. Some patients can walk through the pain reasonably well, whilst others may not be able to weight bear at all. The achilles tendon itself may or may not be swollen, may or may not have a distinct lump, and may either be tender at a specific site, or throughout the tendon. As a result, it is important that your podiatrist consider the entire history and presentation of the issue.

Achilles tendinopathy is usually an overuse condition of the tendon, where over time small micro tears in the tendon can occur which can cause a disruption to the fibres in the tendon, as well as encourage the growth of neovessels, or irregular new small blood vessels. Increased forces placed through the feet, such as those experienced with running, can increase the development of achilles tendinopathy.

Achilles tendinopathy may come about after an increase in training activity, change of footwear, or change of running surface. It may also occur as a result of your personal mechanics – limited muscle flexibility, weak calves, flat feet, feet that roll in excessively, and genetics can all also play a part.

There are a number of treatment options for achilles tendinopathy, dependant on the cause. It could be as simple as a change in training routine. Changes to footwear and orthotic treatment can often settle achilles pain very quickly. Stretching and strengthening programs will also usually be issued by your podiatrist and physiotherapist.