The Achilles Tendon: So Strong, but at Risk for Injury

By Jessica Doporcyk, PT, DPT for Athletico

What is the Achilles Tendon?

achilles tendon pain and injuriesThe Achilles tendon is the point of connection for primarily two muscles which make up the bulk of the calf. It is responsible for performing the motion of lifting the heel off the ground. The Achilles tendon is located just above the heel bone where it attaches.  Although it can bare high loads, acute and chronic Achilles tendon pathology continues to be involved in 50% of all sports related injuries.  In addition, there continues to be a rise in Achilles tendon ruptures (complete tear), of which 75% occur in men between the ages of 30-49 while participating in sports.

Types of Pain

Achilles tendinitis, is one of the most common diagnoses related to Achilles tendon pain. Achilles tendonitis is an inflammation in the Achilles tendon that is usually caused by a single episode or traumatic event. Pain in this area may also be caused by a repetitive injury or previous traumatic, chemical, or pathogen induced injury.  Ongoing research is finding that due to a failed healing response to an initial injury, individuals may experience on-going mechanical changes to the tendon, resulting in weakness. Chronic symptoms of this nature are typically diagnosed as Achilles tendinosis or tendinopathy. Current research suggests that Achilles tendinopathy occurs in 7-9% of top-level runners, but can also develop in individuals who do not participate in sports activities1.

What Leads to Achilles Tendon Pain

Lower limb alignment and biomechanical faults may play a role in the development of Achilles tendon disorders for approximately two-thirds of athletes.  Hyper-pronation, or over flattening of the arch of the foot, can also put a person at higher risk.  It has also been shown that diabetes and metabolic changes may be risk factors, in addition to age and gender. NSAID’s and corticosteroid injections can further increase weakness in an already degenerated tendon.

Individuals may notice their pain at both the beginning and shortly after the end of an exercise session. Typically, a single leg heel raise will cause pain. If it worsens, pain may be experienced throughout the exercise activity or during daily activities.  Typically in the initial phase of the injury or failed healing response, the tendon is swollen and tender just above where it inserts in to the heel.  In chronic or prolonged periods of pain in the Achilles tendon, exercise induced pain is one of the main symptoms that a person will report.

If you’re experiencing pain in your Achilles tendon, please click here to schedule a complimentary injury screen with an Athletico Physical Therapist near you.