Pain in the back of the lower calf or heel or difficulty when walking could be Achilles tendon pain and needs immediate treatment
The Achilles tendon and what it does
The Achilles tendon is the largest tendon in the body and it attaches the very powerful calf muscles to the heel bone (calcaneus) and lies at the back (posterior) of your leg. The Achilles tendon enables us to lift our heel which means its proper functioning is vital for us to walk and run, even for us to stand on the tips of our toes.
There are three aspects to the Achilles of which any one section, or all three, can become painful. The tendon is split between its insertion portion and the peri/ paratendon, and there is also a bursa which is a small sac of fluid that lies between the bone and the tendon itself. This small sac of fluid serves to allow the tendon to glide friction-free on the calcaneus bone.
Stages of Achilles tendon pain
In its beginning stages Achilles tendon pain is quite often said to be tendonitis, which is an inflammation of the tendon due to repetitive micro trauma. When the bursa is involved this is referred to as Achilles bursitis. However when the issue has been present for a prolonged period it is often referred to as a tendonosis, which is a chronic condition denoted by degradation, weakening and misalignment of the tendon fibres during the repair phase. There may also be a bone spur present between the tendon and its bone insertion.
Causes of Achilles tendon pain
We are often asked as clinicians what is the main reason for an Achilles problem, but there is no quick answer to this question. Quite often there are several factors at play in the development of Achilles problems. Causes can often be:
- Tight calf muscles
- Weak calf muscles
- Ill-fitting or poor choice of footwear
- Poor gait mechanics/misalignment
- Increase in running activities too quickly
- Hill/step running
There are many more factors, and patients may have a combination of multifactorial issues or could just have one issue.
It is very important to have an Achilles problem attended to, as the tendon issue can become chronic, leading to debilitating pain. Patients often have to stop sport due to pain and some patients find it difficult to continue in their daily work commitments. The biggest issue facing chronic tendon problems is the ability of the tendon to rupture, which can lead to surgical repair and a very lengthy rehab.
Remember, pain is our bodies’ way of saying there is a problem. So stop and fix the problem – it is often the people who ignore pain, or push through the pain, who take the longest to heal. Unfortunately, there are no quick fixes in Achilles tendonopathy as, unlike muscles, tendons and ligaments have a low blood supply and can take a long time to repair.
If you are experiencing any problems with your Achilles you should see a qualified podiatrist for diagnosis and treatment plan.