Achilles Tendinosis And Other Causes Of Achilles Pain
There are a number of pathologies associated with Achilles tendon pain of which Achilles tendinosis is one of them, indicating degenerative change is present. Achilles tendonitis indicating inflammation is present and Achilles tendinopathy the medically preferred term indicating the possibility of inflammation, degeneration and tears being present. Other common causes of Achilles pain can include peritendinitis and retrocalcaneal bursitis respectively indicating inflammation of the sheath around the Achilles tendon or the fluid sac at the insertion of the Achilles tendon into the heel bone.
Achilles Tendon Rupture
A devastating cause of Achilles tendon pain is an Achilles tendon rupture. Achilles tendon rupture is a complete tear of the Achilles tendon this injury is generally the result of sudden accelerations when running such as pushing off in netball, tennis or football codes. Achilles tendon ruptures that I see in my Sydney physio clinic are mostly middle-aged people participating in sports in their spare time.
With an Achilles tendon rupture the individual may hear a snap or popping noise when the tendon tears and frequently there is bruising and swelling coupled with a significant loss of power in actions requiring pointing of the toes. This injury requires immobilisation and orthopaedic assessment sooner rather than later to consider the relevance of any surgical intervention. Rupture of the Achilles tendon is frequently managed with surgical intervention, followed with an extended period of immobilisation and extended physiotherapy rehabilitation.
Symptoms Of Achilles Tendinopathy
Pain is the most obvious and common symptom associated with Achilles tendinosis and tendinopathy. The pain is usually experienced when stretching the tendon or loading it like running or performing a heel raise.
Some People Also Experience:
- Stiffness In The Tendon: This stiffness is frequently first thing in the morning or at the beginning of exercise and lessens during activity only to worsen when cooled down after activity.
- Swelling: The Achilles area may be swollen, red and warm on palpation if there is inflammation.
- Tenderness on palpation: This may be anything from mild to severe pain and tenderness when the area is touched or bumped. There may also be a palpable lump around the site of pain.
- Reduced strength: A loss of strength and power with a feeling of sluggishness in the leg is sometimes reported with Achilles tendinopathy.
Achilles tendinopathy can be graded according to severity. The following is a grading guide with Grade 1 being mild and Grade 4 being considered severe symptoms.
- Grade 1 – Individual experiences pain after running only.
- Grade 2 – Individual experiences pain before and after running, yet the pain lessons during a run.
- Grade 3 – Individual experiences pain with activity causing them to decrease their volume of activity.
- Grade 4 – Individual experiences pain during everyday activities.
Diagnosing Achilles Tendinosis
Getting an understanding of the history and behaviour of the Achilles pain is key to making diagnosis. Coupling this with a physical examination of the area your physiotherapist will be able to get a good understanding of the condition. In some situations ultrasound and/or MRI imaging is useful for gauging the true extent of any degeneration, tears, and inflammation present or the presence of any peritendinitis or retrocalcaneal bursitis which could be contributing to your Achilles tendon pain.
Disclaimer: Sydney Physio Clinic provides this information as an educational service and is not intended to serve as medical advice. Anyone seeking specific advice or assistance on Achilles Tendinosis A Common Cause Of Achilles Tendon Pain should consult his or her physiotherapist, sports medicine specialist, orthopedic surgeon or otherwise appropriately skilled practitioner.