Also know as or related to:
Achilles tendonitis, Achilles tenosynovitis, Achilles tendonopathy, torn Achilles, calf strain, calf tear, calf pain, soleus strain, soleus pain, gastrocnemius
Description:
This page describes Mid-Portion Achilles Injuries which are Achilles injuries above the level of the heel bone. For lower down Achilles injuries where the Achilles joins the back of the heel bone (calcaneus) then please see our page dedicated to Insertional Achilles Tendonitis by clicking here.
Achilles tendonitis refers to inflammation of the Achilles tendon. The Achilles tendon is a strong tendon that attaches the powerful calf muscle to the back of the heel bone.
The calf muscle produces the power to drive your forward with running and a huge amount of load is transferred through the Achilles tendon to the foot. The strong fibres of the Achilles tendon sometimes can’t handle this load and begin to tear.
Symptoms:
There are different degrees of tearing that can happen to these fibres of the Achilles tendon that can vary the symptoms.
- Mild tear – only some of the fibres are torn causing localised swelling
- Moderate tear – the majority of fibres are torn causing significant swelling and loss of function
- Severe tear – the Achilles tendon can completely rupture with all fibres tearing causing full loss of function
Causes:
There are many possible contributing factors for Achilles tendonitis. The most common causes in the athletic population are related to a sudden increase in the force put through the Achilles Tendon. This increased force can be related to:
Achilles tightness
- Tight calf muscles or short Achilles tendons alter gait mechanics, forces and tensions through the Achilles.
Pronation
- 30% of the workload of the calf of the Achilles is to reduce pronation by stabalising the heel bone. Excessive pronation increases the force through the calf and achilles.
Running technique
- forefoot runners place more strain through the Achilles tendon as the calf muscle has to work to slow down the heel by working in reverse (eccentrically) and then by contracting normally to push you forward. It has been proven that forefoot runners experience more Achilles injuries.
Treatments:
- Promote healing through traditional rest, ice, stretching, massage, etc.
- Reduce load by addressing a tight Achilles, reducing pronation with shoes and orthotics and improving run technique.
- Increase strength by implementing an eccentric loading program. The lowering component of these calf exercises triggers receptors in the Achilles tendon that stimulates healing. Evidence shows that 85% of patients will make a full recovery within 6 weeks with the correct implementation of this program.
Shoes Feet Gear podiatrist demonstrates how to perform this type of exercise in the video below. Consult one of our podiatrists to confirm the type of injury, the severity and to prescribe the right type of exercises with the correct repetitions and sets.
Summary:
The early diagnosis of Achilles injuries is crucial to facilitate rapid healing and a full return to sport before a more serious rupture occurs. Finding the causes of this injury is critical to preventing the problem recurring.