The Achilles tendon binds the two large calf muscles to the back of the heel bone. Achilles tendonitis is caused by ongoing, excessive stress. The problem can be located on the connection between the tendon and the heel, on the tendon sheath or a bursa on the front of the tendon. The cause is always an imbalance between the stress imposed and the capacity of the tendon to withstand it. In serious cases, the Achilles tendon may even tear. The injury tends to affect sports which involve explosive movements, jumps and running.
- The pain is localised in the lower leg, above the heel bone, i.e. the connection between the calf muscles, and can be felt when pressure is applied.
- The pain may occur after exercise and then suddenly disappear.
- It can also occur at the start of exercise (starting pain). Sometimes the sports person can exercise ‘through the pain’. The pain may disappear after warming-up and come back when cooling-down.
- In more serious forms, the pain continues during exercise and even when resting
- The tendon feels swollen and painful (sometimes makes creaking noises)
- Movement limitations and loss of function, principally after exercise
- When standing up, the runner often feels stiff.
Treatment involves rest to begin with and applying ice. Once the swelling has reduced, the calf and ankle must be thoroughly stretched. Always take pain in the Achilles tendon seriously and refer the sports person to a doctor so that the underlying causes can be investigated. The basis of the injury is always an imbalance between the stress applied and the capacity of the tendon to accommodate it. Both the stress applied and the corresponding capacity must be tackled in order to avoid recurrences.
- The cause of Achilles tendonitis is often worn or old shoes or a different surface, such as loose sand. So make sure you have good shoes with adequate shock absorption.
- Don’t overdo it! The stress will be greater than your body can take. Don’t build things up too quickly and don’t train too much at high intensity.