Achilles tendon pain - causes and therapy

An extremely persistent symptomatology is the appearance of Achilles tendon complaints (pain on the Achilles tendon), especially Achilles tendon pain. The symptoms (achillodynia) are a painful inflammation of the tendon tissue of the Achilles tendon. The Achilles tendon allows the foot a powerful repulsion from the ground as it is necessary when running and jumping. Therefore, the pain typically occurs in running, jumping and ball sports because the Achilles tendon is exposed to a permanently high load.

contents

• causes
• Functional causes of Achilles tendon pain
• therapy
• complications

causes

Achillodynia is a pain syndrome of the Achilles tendon that belongs to the group of insertion endopathies. It is an inflammatory reaction of tendon tissue to mechanical damage due to overloading. The smallest injuries in the depth of the tissue, so-called microtrauma, lead to the scarring of the same. The rubbing of the scarred tissue at the tendon sheath initially only causes pain to the affected person upon commencing an activity, since the tendon sheath warms up and expands under the load. In the further course, however, this compensation mechanism is exhausted and the tissue of the Achilles tendon increasingly scarred until it eventually becomes inflamed. The local, usually chronic overloading of the Achilles tendon, as it occurs in the abovementioned sports, both by a constantly constant as well as by a short unfamiliar load, is to be regarded as the main cause of the pain.

Pain of the Achilles tendon often occurs after heavy stress and can be a considerable impairment in everyday life. (Bidl: SENTELLO / fotolia.com)

In addition, joint malpositions of the lower limb can lead to Achilles tendon pain: the job of the tendons in the human body is to guide and limit movements. If, for example, there is a malposition of the foot, it can cause a shift of the Achilles tendon when the calf muscle causes the heel to leave the ground. If the tendon rubs against surrounding structures, pain may arise. Also, degenerative changes in the foot area, such as osteoarthritis, can cause pain in the region. Further, the pain can be caused by infection or metabolic diseases. Examples include diabetes mellitus, arthritis and gout. Other causes may include obesity, increased tension on the shallow flexor muscles, and inappropriate footwear in which forefoot movement is restricted.

Pain in the Achilles tendon can have various causes. (Image: bilderzwerg / fotolia.com)

Functional causes of Achilles tendon pain

The affected person expresses permanent Achilles tendon pain either as it progresses, or typically two to six centimeters above its insertion on the heel bone. At this point, the blood circulation of the tendon is already low anyway. There, the tissue is swollen, warmed and "tender-painful". Particularly pronounced pain during movement and especially under stress describes the person affected after long periods of rest, such as in the morning after getting up. Then the pain decreases again. Those affected complain now rather an unpleasant pulling. In a chronic course, the tendon is thickened.

therapy

Achilles tendon pain is treated conservatively physically and medically. The tendon must be relieved depending on the severity and stage of inflammation. For painful changes, painkillers and anti-inflammatory medications such as ointment dressings and ice cream are often administered first. Further therapeutic measures are expansions of the superficial flexor muscle of the lower leg, possibly in conjunction with heat therapy. Ultrasound is also increasingly being used in the treatment of achilles tendon pain. The shock waves emitted by the quartz crystal stimulate the circulation of the tissue, promote absorption and loosen the tissue. A DC therapy promotes the circulation of the foot and lower leg. For more severe symptoms, both therapies combined with ointments can be intensified. Also, acupuncture and laser treatment of the tendon are often successful.

complications

As a rule, the symptoms have a good prognosis. However, if they become chronic and left untreated, there is a risk of heel spurs or tearing of the Achilles tendon. (Philipp Schulz, physiotherapist)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)