Achilles tendonitis / tendinopathy
Achilles tendonitis/ tendinopathy is a painful condition that can cause pain at the back of the heel with every step taken.
Achilles tendinopathy refers to degeneration within the large tendon which joins the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).
It also is the most frequently ruptured tendon, usually as a result of a sports injury. Both professional and weekend athletes may suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.
Achilles tendinopathy refers to degeneration within the large tendon which joins the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus).
It also is the most frequently ruptured tendon, usually as a result of a sports injury. Both professional and weekend athletes may suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.
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Achilles tendon pain commonly occurs from shearing and stretching forces placed on the Achilles tendon leading to microscopic tears within the substance of the tendon - the body commences an inflammatory response to repair the tears, this is part of the healing process. With repetitive stresses the inflammation is prolonged and so results in local tissue damage. 
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Based on the location of your pain, there are two types of Achilles Tendinopathy:
- Mid-Portion Achilles Tendinopathy – isolated to the area above the heel bone. The most common form and often easier to treat.
- Insertional Achilles Tendinopathy – pain stems from where the Achilles tendon attaches to the heel bone. This type is often more stubborn and requires extra tender care.
Achilles tendon pain may be felt during activity and often begins with mild pain after exercise or running that gradually worsens.
Tenderness can be felt along the course of the tendon and in some cases there may be the presence of a localized nodule (small sack of fluid) on the tendon.
Cumulated microtraumas from repetitive overloading can result in chronic tendinopathy (tendinitis or tendinosis).
Both inflammation of the tendon and damage on the cellular level are successfully treated with Shockwave therapy, together with a tendon strengthening rehabilitation program. The number of shockwave therapy sessions is typically 3-6 with 5-10 days in-between sessions.
Treatment also will need to consist of:
Experiencing one or any combination of the following symptoms may be an indication of Achilles Tendinopathy:
Tenderness can be felt along the course of the tendon and in some cases there may be the presence of a localized nodule (small sack of fluid) on the tendon.
Cumulated microtraumas from repetitive overloading can result in chronic tendinopathy (tendinitis or tendinosis).
Both inflammation of the tendon and damage on the cellular level are successfully treated with Shockwave therapy, together with a tendon strengthening rehabilitation program. The number of shockwave therapy sessions is typically 3-6 with 5-10 days in-between sessions.
Treatment also will need to consist of:
- Rest
- Ice or heat
- Non-steroidal anti-inflammatory medication
- Achilles tendon & calf muscle strengthening and stretching program
- Supportive footwear
- Orthotics
- Shockwave therapy (Extracorporeal shockwave therapy (ESWT))
Experiencing one or any combination of the following symptoms may be an indication of Achilles Tendinopathy:
- Gradual onset pain following a run and frequency of pain increases on following runs
- Pain when squeezing the tendon above the heel bone (type: Mid-Portion)
- Pain when pressing the location where the tendon inserts into the heel bone (type: Insertional)
- Swelling, and if chronic, thickening of the tendon
- Pain walking up and/or down stairs
- Pain walking up hills
- Pain walking on toes
- Pain squatting (type: Insertional)
- Pain when transitioning from prolonged period of sitting to walking or first steps in the morning
- Pain with hopping and/or jumping
- Morning tenderness at the point where the Achilles tendon is attached to the heel bone.