Achilles tendinopathy

Pain in the back of the lower calf or heel calls for urgent treatment

Where is the Achilles tendon and what does it do?

The Achilles tendon is actually the largest tendon in the body. It attaches the very powerful calf muscles to the heel bone (calcaneus) and lies at the back (posterior) of your leg. The Achilles tendon enables us to lift our heel, which means its proper functioning is vital for us to walk and run, even to stand on the tips of our toes.

There are three aspects to the Achilles, of which any one section, or all three, can become painful. The tendon is split between its insertion portion and the peri/ paratendon. There is also a bursa, a small sac of fluid that lies between the bone and the tendon itself. The bursa allows the tendon to glide friction-free on the calcaneus bone.

What are the different types of Achilles tendinopathy?

  • In its early stages, Achilles tendon pain is often said to be tendonitis, which is an inflammation of the tendon due to repetitive micro-trauma. 
  • When the bursa is involved this is referred to as Achilles bursitis.
  • When the issue has been present for a prolonged period, it is often referred to as a tendinosis, which is a chronic condition denoted by degradation, weakening and misalignment of the tendon fibres during the repair phase.
  • There may also be a bone spur present between the tendon and its bone insertion.
  • The biggest issue facing chronic tendon problems is the ability of the tendon to rupture, which can lead to surgical repair and lengthy rehab.

What causes Achilles tendon pain?

As clinicians, we are often asked what is the main reason for an Achilles problem, but there is no simple answer to this question. Quite often there are several factors at play in the development of Achilles problems, which can be:

  • Tight calf muscles
  • Weak calf muscles
  • Ill-fitting or poor choice of footwear
  • Poor gait mechanics/misalignment
  • Increase in running activities too quickly
  • Hill/step running

There are many more factors, and patients may have a combination of issues or just one.

See a podiatrist without delay for your foot’s tendon pain

It is vital to have an Achilles problem attended to, as the tendon issue can become chronic, leading to debilitating pain. Patients often have to stop sport due to pain and some patients find it difficult to continue in their daily work commitments. 

Remember, pain is our bodies’ way of saying there is a problem – so stop and fix the problem. It is often the people who ignore pain, or push through the pain, who take the longest to heal. Unfortunately, there are no quick fixes in Achilles tendonopathy as, unlike muscles, tendons and ligaments have a low blood supply and can take a long time to repair.

If you are experiencing any problems with your Achilles you should see a qualified podiatrist at The Foot Group for diagnosis and a treatment plan.

Our Lane Cove clinic at Shop 3, 152-154 Longueville Road

Lane Cove

Shop 3, 152–154 Longueville Road

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Tel 9428 3000

Our Brookvale clinic at Suite 144, 117 Old Pittwater Road

Brookvale

Suite 144, 117 Old Pittwater Road

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Tel  9938 2222