Achillodynia - when the Achilles tendon hurts
Even in Greek mythology, the Achilles tendon of the mythical hero Achilles was a vulnerable part of the body. The Achilles tendon is also a sensitive weak point for many people who are active in sport. Persistent, load-dependent discomfort and pain in the area of the lower calf and Achilles tendon is known as achillodynia. It is one of the most common sports injuries. It often affects professional athletes as well as amateur and recreational sportspeople who regularly take part in sports that involve a lot of running and jumping. However, people who are overweight, suffer from rheumatism or have foot misalignments can also suffer from Achilles tendon pain.
The Achilles tendon is the strongest and thickest tendon in the human body. It transfers the strength of the calf muscles to the foot. This makes movements such as standing on your toes, jumping off and running possible. Although the Achilles tendon is designed for high loads, it has a high risk of injury. Constant strain causes tiny injuries (microtraumas) in the tendon. Such injuries often take a long time to heal, as the metabolism and blood supply to the Achilles tendon are inadequate in some places. As a result, structural, degenerative damage to the Achilles tendon can progressively develop. After a few years, the tendon can even rupture.
The symptoms of Achillodynia
Symptoms include pain on exertion (e.g. standing on toes) or passive stretching, finger pressure on the tendon as well as redness and warming of the skin on the affected side. The first symptoms occur after an unusually heavy load and slowly subside after a few days without further action. With persistent, progressive Achillodynia, the pain occurs even during moderate exertion. The tendon becomes increasingly thickened and the pain quickly returns or persists even after a period of rest. Movement and sport are only possible with pain. Later, everyday activities such as climbing stairs or walking can only be carried out with severe pain or not at all. In this condition, the damaged Achilles tendon can hardly regenerate without targeted therapy.
Various factors influence the development of a chronically painful thickening of the Achilles tendon
Sporting activities
- Unaccustomed strain such as running on hard or uneven ground
- Extensive, intensive training sessions with running and jumping loads
- Too short regeneration phases
- With poor general training condition increases the risk of a sports injury
External factors
- Incorrect footwear during sports and in everyday life can lead to incorrect loading of the foot and shortening of the Achilles tendon
- Smoking impairs the general metabolism and can delay the regeneration of overloaded tissue
- Cortisone therapies can damage connective tissue and tendons
Internal factors
- With increasing age the general ability to regenerate decreases and the tendons are less resilient
- Overweight leads to chronic overuse of tendons and joints
- Foot misalignments (e.g. flat feet or weak ligaments in the ankle joints) and shortened tendons and muscles overload the Achilles tendon
- Metabolic diseasessuch as rheumatism, gout, increased uric acid and blood lipid levels can damage tendons and make them less resilient
Therapeutic treatment methods for achillodynia
Achillodynia is diagnosed by an orthopaedic specialist. A physical examination follows the medical history interview. In addition to a manual examination, imaging techniques such as magnetic resonance imaging (MRI) or ultrasound can be used if necessary. In this way, an Achilles tendon rupture can be reliably ruled out (or confirmed).
The treatment of Achillodynia is primarily conservative - surgical measures are not used. Treatment is most successful if it is started as early as possible. The focus is on pain relief and delaying or halting the progression of Achillodynia. Rest is the treatment of choice for acute symptoms. By avoiding the triggering stresses (e.g. running, jumping), the Achilles tendons are protected and the pain can subside.
Initial measures with therapeutic aids
The specialist can prescribe bandages, taping or orthopaedic insoles, such as Tuli's® X-BRACE and SISSEL® Kinesiology Tape. Pain-relieving medication (paracetamol, ibuprofen, diclofenac) or anti-inflammatory ointments can support the healing process. In the acute phase, when the pain occurs directly after sport, mild cooling of the Achilles tendon alleviates the symptoms. Cooling compresses, such as SISSEL® Pack or SISSEL® Hot-Cold Pearl Pack is provided. Once the pain has passed after a few days, the application of heat (e.g. SISSEL® Pack, SISSEL® Hot-Cold Pearl Pack or hot roll) promote blood circulation and thus the healing process.
Further measures
If these simple methods do not provide relief, it is time to consult a physiotherapist in addition to the orthopaedist. On the doctor's orders, the physiotherapist develops individual exercise programs. Practicing eccentric training is very effective. It can be carried out on every step of the stairs without any other equipment. This central physiotherapy exercise should be performed twice a day for up to three months. This exercise example shows how protracted Achilles tendon problems can be.
Additional exercises are necessary for the holistic treatment and prevention of Achillodynia. Trained physiotherapists put together an individual training program for the three areas of strengthening, coordination and stretching. Ideally, this exercise program should be carried out 3 to 4 times a week to achieve the desired improvement. The physiotherapist determines the exact sequence, the choice of exercises and the focus individually.
The three focal points for successful therapy: strengthening, coordination and stretching
Strengthening
Strengthening focuses on the central exercise "calf raise". The exercise can be performed on a step with the knee extended or bent. It is important to perform the exercise slowly as eccentric and concentric training.
Coordination
Coordination exercises are performed on one leg and barefoot. Soft, unstable surfaces, such as a mat, are used as a standing surface. SISSEL Balancefit Pad or SISSEL Balancefitfor advanced users, devices such as SISSEL® Balance Board or SISSEL Balance Board Dynamic on.
Stretching
Shortened tendons and muscles can be "relaxed" with targeted stretching exercises. Following instructions, you can stretch on a gymnastics mat (e.g. a mat). SISSEL Superior Mat or SISSEL Gym Mat) with a fascia roll (e.g. SISSEL Myofascia Roller or SISSEL Massage Roller) can be used to perform various exercises to stretch the calf muscles and Achilles tendon.
Conclusion
Achillodynia can be prevented, avoided and treated if those affected pay attention to their body's signals. Complaints should be taken seriously at an early stage and the tips mentioned above should be followed. Basically, every sportsperson should warm up extensively before training, avoid overloading and allow themselves sufficient recovery time between training sessions. Then sport will support a fulfilled, pain-free life and we will be spared the fate of Achilles.
