Tendons are the thick tissues connecting muscles to joints. The Achilles tendon in the heel area is the largest tendon in the body, and a commonly injured or strained one. Pain or tightness can occur in anyone; however, athletes, people who exercise regularly, and those with tight calf muscles are prone to Achilles tendon issues.
Tendinopathy describes any problem involving a tendon, and involves moving joints such as the ankle, elbow, hip, knee, shoulder, thumb, and wrist.
‘Achilles tendonitis’ and ‘Achilles tendonosis’ are often used interchangeably; however, they are different conditions so require different treatments.
The conditions have similar symptoms, so it is essential that a podiatrist assesses pain or immobility in the foot area. Prompt, appropriate treatment will minimise health issues later.
Tendonitis is short-term (acute) tendon inflammation. Sudden or heavy force on the tendon creates small tears, causing inflammation. With rest and physical therapy, the inflammation may disappear in a few days.
Stretching and warming up (before work or exercise), strength training, and massage will keep the tissue healthy, and may prevent tendon injuries.
Allowing tendons to rest and recover after intense exercise, and when experiencing pain may prevent Achilles tendonosis (a long-term condition) from developing.
Getting prompt treatment for tendonitis is essential to prevent tendonosis.
Symptoms of Achilles tendonitis may include:
- Dull ache
- Tightness and/or swelling
- Pain if touched
Tendonosis is caused by long-term (chronic) overuse of the tendon, which leads to collagen deterioration. Common areas for tendonosis are the heel, knee, elbow, wrist, and shoulder.
Repetitive action stresses the tendon and slows the healing process, leading to tendonosis. Achilles tendonosis is common in middle aged and older people; however, it can occur in people who:
- perform repetitive tasks
- wear ill-fitting footwear
- have tight calf muscles
- have poor posture
- do not stretch before and after sports/vigorous activities
- do not rest and recover after sports/vigorous activities
- have untreated tendonitis
Symptoms of Achilles tendonosis may include:
- pain and/or tightness behind the ankle
- stiffness and restricted movement
- appearance of a tender lump (in some cases)
Inflammation does not occur in tendonosis.