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What is Achillodynia?
Achillodynia is the medical term for pain in the Achilles tendon that occurs in the distal course of the tendon (away from the center of the body). The pain can be localized or diffuse in the peritendineum, the connective tissue that covers the collagen fibres of the tendon from the outside.
In mild cases and with early adequate treatment, the symptoms of Achillodynia can subside within a few weeks or months. Under certain circumstances, chronic Achillodynia can develop.
Causes of Achillodynia
Achillodynia is usually caused by overloading or incorrect loading of the Achilles tendon. It is the strongest tendon in the human body and transmits the force of the calf muscles to the foot.
High loads when running or jumping can overload the Achilles tendon and cause pain, irritation or inflammation. Muscular imbalances can also lead to overloading of the Achilles tendon and promote the development of achillodynia. Certain anatomical features such as foot misalignments, a leg axis misalignment or a shortened Achilles tendon can increase the strain on the tendon and the risk of Achillodynia. Finally, the elasticity of the tendons decreases with age, meaning that pain in the Achilles tendon can occur more quickly.
How can Achillodynia be prevented?
Inactivity generally leads to premature ageing of the tendon. Moderate mobilization therefore has a positive effect on a healthy Achilles tendon. Other preventative measures:
- Plan a warm-up phase before physical activity to increase blood circulation and prepare the muscles and tendons for the strain. It is also advisable to stretch the calf muscles regularly to improve mobility and reduce the strain on the Achilles tendon.
- Avoid excessive increases in training volume or intensity when exercising. The training load should be increased gradually to get the Achilles tendon used to it slowly. Also give the Achilles tendon enough time to regenerate.
- Being overweight can put additional strain on the Achilles tendon. A healthy diet and regular exercise can reduce the risk of Achillodynia
Symptoms and signs of Achillodynia
The clinical picture ranges from irritation to inflammation of the Achilles tendon and the surrounding tissue. This becomes noticeable through pain. Initially, the pain subsides as soon as the strain is reduced or avoided. Later, the pain can also become permanent - both during exertion and at rest.
Acute irritation in the area of the Achilles tendon and the gliding tissue can lead to the inability to walk. In some patients, a thickening similar to a lump or knot forms on the Achilles tendon. The upper ankle joint is often held in a pointed foot position. In some cases, the tendon can rupture.
Typical symptoms are
- Pain: There may be pain along the inflamed Achilles tendon, which intensifies when the tendon i s stressed, for example when walking, running or jumping. The pain can also occur after a long period of rest.
- Restricted mobility: In the case of pronounced Achillodynia, a restriction of movement or a feeling of stiffness of the Achilles tendon may occur, especially after prolonged rest or after getting up in the morning.
- Swelling and redness: Severe inflammation can lead to swelling and redness in the area of the Achilles tendon
Diagnosis: Recognizing Achillodynia
Achillodynia is usually diagnosed through a combination of clinical examination, medical history and imaging techniques. First, a medical history is taken to obtain information about the patient's symptoms, duration of symptoms, previous injuries and activity level.
During the subsequent clinical examination, the area around the Achilles tendon is palpated. This involves looking for swelling, redness and localized pressure pain as well as checking the mobility of the foot and ankle. Imaging procedures such as ultrasound or, less frequently, magnetic resonance imaging can also be used. (MRI) can be used to assess the severity of the inflammation or any structural damage.
A careful differential diagnosis is important to ensure that the correct treatment is initiated. This involves considering and ruling out other possible causes for the symptoms. These include bone fractures, bursitis, heel spurs, nerve irritation or other tendon injuries.
Therapy for Achillodynia: Treatment for pain in the Achilles tendon
Achillodynia therapy aimsto relieve pain in the Achilles tendon and promote healing - at the same time, inflammation can be reduced and relapses prevented. It is initially treated conservatively, i.e. without surgery.
The following methods relieve the pain and can delay or stop the progression of Achillodynia:
- Physiotherapy: Targeted exercises can help to reduce the strain on the inflamed Achilles tendon and promote healing.
- Physical measures: If medically necessary, physical measures such as ultrasound treatments, electrotherapy (TENS), transverse friction (special massages of the affected muscle or tendon fibers), shock wave therapy or acupuncture can be prescribed.
- Supports: Supports can stabilize and provide relief. In the acute inflammatory phase, patients can additionally relieve the Achilles tendon with the help of enclosed heel wedges, which they place in the shoes on both sides.
- Insoles: Special orthopaedic insoles and heel cushions can help to relieve the Achilles tendon and improve the position of the foot.
- Cooling: For acute pain or discomfort, mild cold applications with cooling compresses at refrigerator temperature (approx. 7 degrees) can relieve pain and swelling.
- Warming: In chronic cases, a heating pad, hot water bottle or massage with a hot roll (terry towel dipped in warm water) can provide relief and promote blood flow to the tendon insertion.
- Medication: Depending on need and the doctor's decision, those affected can take pain-relieving or anti-inflammatory medication such as ibuprofen or diclofenac for one to two weeks.
- Ointments: The affected area can be massaged several times a day with anti-inflammatory creams or ointments.
Surgery for achillodynia - when conservative treatment is not enough
In severe cases where conservative treatment methods are unsuccessful, surgery may be considered. This may involve the removal of inflamed tissue, the repair of torn tendons or the correction of structural problems.
The Achilles tendon needs rest in order to recover. In severe cases where conservative treatment methods are not effective, surgery may be considered. This may include removal of inflamed tissue, repair of tendon tears or correction of structural problems. Treatment should be tailored to the individual patient's needs and the exact clinical picture.
Exercises for Achillodynia
A balanced muscle system can reduce the strain on the Achilles tendon and lower the risk of injury. Special exercises for Achillodynia serve to strengthen the calf muscles as well as the foot and lower leg muscles.
Supports and insoles from medi for Achillodynia
The Achimed Achilles tendon support made of compressive knitted fabric can relieve the tendon in cases of Achillodynia: the integrated 3D silicone pads create a gentle massage effect that relieves pain and reduces swelling.
Orthopaedic insoles (e.g. igli Heel or igli Heel Light) .can relieve the irritation situation by providing soft bedding along the plantar fascia and supporting the arch of the foot
