Achilles Tendon & Pain

The Achilles tendon connects the heal bone to the large calf muscles at the back of the ankle. It has a limited blood supply, which contributes to its susceptibility to tears and ruptures. If not properly warmed up prior to exercise, this large tendon is vulnerable to small tears and degenerating tissue with overuse.

Achilles Tendinitis and Tendonosis

• Stiffness, aching, tenderness and soreness in the area of the calf along the path of the Achilles tendon can indicate Achilles tendinitis or tendonosis. The pain usually is worse first thing in the morning, or after a rest. As the day goes on and the tendon is used, the pain can ease, only to recur when activity increases. Soreness or intense pain occurs in a person suffering Achilles tendinitis when the sides of the Achilles tendon are squeezed and eases when the back of the tendon is pressed.

Achilles Tendinopathy

• Achilles tendinopathy is an injury to the Achilles tendon. Usually caused by overuse of the tendon, Achilles tendinopathy can cause structural change within the Achilles tendon that causes pain and swelling. Achilles tendinopathy can sometimes limit movement and it can sometimes take months for the injury to heal and the pain to disappear.
  Pain is usually noticeable first thing in the morning and will gradually worsen during the day. Achilles tendinopathy will cause localized pain in the tendon or radiating pain after running. The area around the tendon may appear swollen.

Achilles Paratenonitis

• With Achilles paratenotis, inflammation is limited to the covering of the Achilles tendon. As fluid accumulates along the tendon, the paratenon, or tendon covering, becomes thick and adheres to the tendon tissue, causing pain with activity that can be relieved by rest.
  The area of the Achilles tendon can feel warm and swollen, and the tendon can thicken if the tendon covering is not allowed to heal.

Retrocalcaneal Bursitis

• Pain in the Achilles tendon area can also be caused by retrocalcaneal bursitis. This is an inflammation of the bursa behind the ankle near the heel bone. Retrocalcaneal bursitis is often confused with Achilles tendinitis.
  The bursa can become inflamed by repeated motions or overuse of the ankle, such as walking, jumping or running. Retrocalcaneal bursitis can be painful to the touch. Walking and running can cause pain in the heel. The pain may increase when standing on tiptoes, or when the ankle is bent upward. The skin over the back of the heel may appear red and warm.

Insertional Achilles Tendinopathy

• Insertional Achilles tendinopathy can lead to constant pain in the back of the heel. It can also interfere with flexing of the foot.
  Exercise, especially running on hard surfaces, can increase the pain of insertional Achilles tendinopathy. An increase in running distance, running on hills and the tendency to land on the heel bone are all thought to be linked to damage to the tendon. The damage to the Achilles tendon can also be caused by a bone spur or other bone growth.