An extremely persistent symptomatology is the appearance of complaints of the Achilles tendon (pain on the Achilles tendon), especially Achilles tendon pain. The discomfort (achillodynia) is a painful inflammation of the tendon tissue of the achilles tendon. The Achilles tendon enables the foot to push off the ground powerfully, as is necessary, for example, when running and jumping. Therefore, the pain typically occurs during running, jumping and ball sports because the Achilles tendon is exposed to a permanently high load.
Achillodynia is a pain syndrome of the Achilles tendon that belongs to the group of insertion tendopathies. It is an inflammatory reaction of tendon tissue to mechanical damage caused by overload. The smallest injuries in the depth of the tissue, so-called microtraumas, lead to scarring of the tissue. Rubbing the scarred tissue on the tendon sheath causes pain to the affected person only when starting an activity, since the tendon sheath warms and expands under stress. In the further course, however, this compensation mechanism becomes exhausted and the tissue of the Achilles tendon becomes increasingly scarred until it ignites at some point. The local, mostly chronic overload of the Achilles tendon, as occurs in the above-mentioned sports, due to constant and short, unfamiliar loads, is the main cause of the pain.
In addition, malpositioned joints of the lower extremity can lead to Achilles tendon pain: the task of the tendons in the human body is to guide and limit movements. If, for example, the foot is misaligned, the Achilles tendon can be displaced if the calf muscle causes the heel to leave the floor. If the tendon rubs against the surrounding structures, pain can occur. Degenerative changes in the foot area, such as arthrosis, can also cause pain in the region. The pain can also be caused by infectious or metabolic diseases. Examples include diabetes mellitus, arthritis and gout. Other causes can include being overweight, increased tension in the superficial flexor muscles of the lower leg, and wearing unsuitable shoes that restrict the forefoot movement.
Functional causes of Achilles tendon pain
The affected person expresses permanent pain in the Achilles tendon either in its course or typically two to six centimeters above its base on the heel bone. At this point the tendon blood circulation is already low. There the tissue is swollen, warmed and "tender to pressure". The affected person describes particularly pronounced pain when moving and especially when exercising after long periods of rest, such as in the morning after getting up. Then the pain subsides. Those affected now complain of an unpleasant pull. With a chronic course, the tendon is thickened.
Achilles tendon pain is treated conservatively physically and with medication. The tendon must be relieved depending on the severity and stage of the inflammation. In the case of painful changes, pain and anti-inflammatory drugs such as ointment bandages and ice cream are often administered first. Other therapeutic measures include stretching the superficial flexor of the lower leg, possibly in conjunction with heat therapy. Ultrasound is increasingly being used in the therapy of Achilles tendon pain. The shock waves emanating from the quartz crystal stimulate the blood circulation in the tissue, promote absorption and loosen the tissue. DC therapy promotes blood circulation in the foot and lower leg. For more severe symptoms, both therapy methods can be intensified in combination with ointments. Acupuncture and laser treatment of the tendon are also often successful.
The symptoms usually have a good prognosis. However, if they become chronic and remain untreated, there is a risk of heel spurs or an Achilles tendon tear. (Philipp Schulz, physiotherapist)
Author and source information
This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Editor Heilpraxis.de, Barbara Schindewolf-Lensch
- Giorgio Tamborrini; Christian Marx: "CME rheumatology 6 / resolution of persistent Achilles tendon pain", in: Praxis, Volume 104, 2015, Hogrefe
- Christian Plesch; Rainer Sieven; Dieter Trzolek: Handbook Sports Injuries, Meyer & Meyer Sport, 2015
- Anthony C. Egger; Mark J. Berkowitz: "Achilles tendon injuries", in: Current Reviews in Musculosketal Medicine, Volume 10 Issue 1, 2017, NCBI
- Desiderius Sabo; Stefan Rammelt: Hindfoot Surgery, Springer, 2017
- Carl Joachim Wirth; Ludwig Zichner: Orthopedics and Orthopedic Surgery - Fuß, Thieme, 2002