What is Achilles tendonitis? Symptoms and Causes

Achilles tendinitis (or Achilles tendinopathy) arise from an irritation or inflammation of your Achilles tendon. The main symptoms include feeling pain while running or after the run and feel stiff or tight when walking. If this happens more regularly, an athlete will always think if they should pause running or continue with their runs.

Maybe you’ve already been advised to ice and rest your Achilles tendinopathy – it works but there’s more! In this post, I’ll discuss the Achilles tendinopathy in details – its symptoms, causes, and possible treatments.

Achilles tendinopathy Overview

Achilles (uh-KILL-eez) tendon is found at the back of your ankle and it links the calf muscles to the back of your heel bone. It arises from tendon overuse in high-intensity or high-speed jumping, walking on stairs or running – particularly on soft grounds like sand.

Additional extrinsic and intrinsic risk factors for tendinopathy are rheumatoid arthritis, not wearing the right Achilles Tendonitis shoes for running and limited body exercise. The conditions mainly occur in old-aged and middle-aged persons taking part in sports like athletics and basketball, tennis – especially when they participate only during weekends.

For treatment, many doctors recommend physical exercise/ therapy, non-steroidal anti-inflammatory agents (NSAIDs), platelet-rich plasma (PRP) injections, RICE method, and other Self-care. Such strategies can help athletes prevent the re-occurrence of the conditions.

Symptoms

Save for the sever Achilles tendon tear, most people experience a progressive increase in the pain on the tendon. However, tendon rapture would cause instantaneous and sharp pain. In both cases, you’ll definitely feel pain and have challenges when trying to pointing the toes when moving or stepping. 

 Therefore, pain above the heel, at the back of your leg, is the most prevalent symptom for Achilles tendinopathy. 

The pain increases when one is standing on the toes, stretching the ankle – particularly when playing tennis, basketball or running – but might continue when you’re resting or taking a walk. Further, you might feel that the Achilles tendon becomes stiff, distended and tender.

Therefore, the summary of the symptoms for Achilles tendinopathy in many patients are: 

1. Achille tendon pain – Due to overuse, you’ll feel pain on the area in which the lower calf muscles meet the tendon. Mild ache at the back of your heel or back of the leg. It’s rare that you’ll feel pain Heel Pain – near the heel bone. While at it: Check if heel pain is triggered by Plantar Fasciitis or Heel Spurs.

2. Muscle stiffness and general swelling – You’ll note stiffness and swelling at the are which the Achilles tendon meets your heel. For Achilles tendinopathy, it’s mainly a “morning after” stiffness. The ankle might also have lower motion range and less strength. 

4. Pump bump at the back of your heel – In addition, you might note some bony bump at the back of your heel – this is commonly described as Haglund’s deformity. In case of a tendon tear, you’ll hear a popping or snapping sound coming from the area near the tendon. Equally, the tendon might also swell or get some bruises. 

5. Hotness and Redness – You’ll note that the skin over your Achilles tendon will feel hot and appear reddened. In addition, you might feel some tenderness on the region too. 

Orthotics or heel lift can also assist in relieving the symptoms. If symptoms persist past 6 months, the Achilles tendinopathy could require tendon rupture surgery – especially when a tendon (tear) occurs.

Causes

High-intensity and high-speed running and exercise are the main causes of Achilles tendinopathy. But there are other extrinsic and intrinsic factors, such as infection or Rheumatoid arthritis that trigger Achilles tendinopathy. However, the following repetitive and strenuous loading of your Achilles tendon might also cause Achilles tendinopathy.

Extrinsic causes (training or shoes)

Wearing worn-down or incorrect shoes or orthotics can also trigger Achilles tendinopathy as you’ll lack the required support for your natural foot pronation.

Achilles tendinopathy can also arise from an overuse of the Achilles tendon. Tendon overuse comes up from putting repeated strain and stress as it happens among marathon, long-distance, and endurance runners.

If you suddenly increase in the intensity of jumping, walking or plyometric exercises, you risk developing Achilles tendinopathy. Thus, eccentric exercises such as Alfredson Protocol would help you heal your Achilles tendinopathy.

Physiological Causes  

First, synovial sheaths around the Achilles tendon could supply limited or poor quality (pressure) blood – and hence cause Achilles tendinopathy. Therefore, the limited blood supply to the tendon would trigger swelling and degeneration of the Achilles tendons’ collagen fibers.

The  Achilles tendon injury will experience slower healing with low blood supply. Equally, during the injury cells will move from the structured around the Achilles tendon to cover the tendon – which could include cells from blood vessels and nerve fibers that could be the cause of pain.

Mechanical Causes

Calf muscles’ tightness can also trigger the start of Achilles tendinopathy. In your normal exercises, walking and running, your foot and ankle tend to supinate and pronate at about 5 degrees. However, over-pronation of your subtalar joint might also trigger the development of Achilles tendinopathy.

Conclusion

Despite that Achilles tendonitis is more prevalent among athletes (mainly runners), it can happen in your regular walking, jumping or when you participate in sports such as basketball or tennis.

The injury particularly happens when you increase your speed, length and intensity of your running or training too rapidly – such as training hard only during the weekends.