Achilles pain due to Achilles tendinopathy, tendonitis, or tendonosis is a condition that is characterised by pain and tissue damage in the Achilles tendon. Achilles tendinopathy happens when the Achilles tendon becomes injured, causing swelling and pain in the lower leg. The Achilles tendon is a strong band of fibres that connects two calf muscles in the leg to the heel bone.
The most common cause of Achilles tendinopathy is excessive exertion in the Achilles tendon, and it is worsened by an overload caused by wrong plantar biomechanics while walking or running. Poor footwear and tight calf muscles may also play a part.
Achilles tendinopathy is an unfortunately common complaint seen among many clinics. Achilles tendon pain is usually due to small tears in the tendon which can develop over time. This may occur due to a single incident of over-stretching or straining the tendon, or through general overuse wherein the tendon becomes worn and damaged.
Several factors can contribute to the development of Achilles tendonitis. These include:
- Wearing high-heeled shoes that shorten and tighten the calf muscle
- A sudden increase in the amount of weight bearing training such as walking or running
- Poor footwear that rubs against the tendon or does not support the foot adequately
- Training on hard or uneven surfaces, e.g. road running, beach running, and running up hills is notorious for this
- Insufficient stretching and/or recovery between training sessions
- Poor foot biomechanics – excessive pronation is the most common
- Weight gain.
Achilles symptoms include pain in the Achilles tendon, heel or lower calf. Tenderness to pressure, redness, and swelling are common. There may be difficulty rising up onto your toes, particularly when standing on 1 leg only. In some cases, it can be difficult to put the foot on the floor after a training session, or upon your first step in the morning.