Foot Pain & Achilles Tendon Ankle Pain
Achilles Injury / Tendinopathy
What is the Achilles Tendon?
Foot pain at the rear of the ankle may be Achilles in origin pain. The Achilles tendon is a combined tendon of the two muscles in the calf, the larger muscle being Gastrocnemius and smaller muscle being Soleus. This tendon is the strongest tendon in the body, it can still become overloaded or suffer from overuse resulting in pain and discomfort.
What is Achilles Tendinopathy?
Achilles tendinopathy refers to any problems with the Achilles tendon, the part of your body that connects the calf muscle to your foot via your heel bone.
The ‘-opathy’ part refers to a disorder of the tendon and is used as an umbrella term to cover a range of issues that can affect the Achilles tendon.
Problems with the Achilles Tendon are graded:
- Grade I: Mild strain.
- Grade II: Moderate strain.
- Grade III: Complete rupture
What causes Achilles pain?
This is caused by a condition call Achilles Tendinopathy (previously called Achilles tendonitis as it is now known that the Achilles does not inflame). The condition is typically seen in running and jumping type activities and does develop in those who do not play sport. The incidence of increased tightness can increase during the summer months as people are more inclined to wear flat sandals / flip-flops for longer periods and this type of footwear results in a longer stretch being applied to the Achilles tendon which can result in developing tendinopathy. Flat shoes or walking barefoot increases the pressure & tension within the Achilles tendon.
As the tendon becomes overloaded it often becomes thicker in the middle of the tendon just above (approx 5 cm above) where the Achilles tendon inserts in to the heel bone. It will feel tight and sore first thing in the morning or when starting exercise. Pain may also start during exercise as the tendon tires and will often continue even after stopping the activity.
Insertional Achilles Pain
This is more complex and can be related to a number of influencing factors including tendinopathy, inflammation of bursa and pressure from the heel bone. You would require advice from a Podiatrist or Physiotherapist to help improve the condition so if your pain is more pinpoint to where the Achilles tendon actual inserts into the heel bone please contact your doctor
How do I treat Achilles tendinopathy?
The tendon is painful and thickened, this occurrs because it is too weak to cope with the loads placed upon it. As weakness is already part of the problem, absolute rest is only going to make the problem worse by contributing to the weakness, but you should consider trying to avoid activities that bring on the pain. Achilles pain responds well to Calf stretching exercises and simple heel drop exercise which in many cases resolves the problem. The exercise will be painful at first and should be carried out each day with the expectation that you will need to do this exercise for up to 3 months. If every day working is causing you Achilles pain you may wish to consider wearing a shoe with a small heel or a small heel raise in your shoe to reduce the stretch the tendon is experiencing. This alone will not resolve pain and must be done in conjunction with the stretching exercise. Care must always be taken when stretching not to cause more pain or possible achilles rupture.
Prescription Orthotic Insoles
Prescription orthotic insoles are also used to help the recovery process and assist with ongoing prevention of future issues. During the digital assessment at Waverley Foot Clinic we often identify other linked factors which can be included within the prescription, aiding long term foot health and mobility. Please watch the youtube link which demonstrates how bio- mechanical assessment can diagnose and treat foot pain issues. http://waverleyfootclinic.com/orthotics/