Achillodynia - Achilles tendon pain

The Achilles tendon connects the calf muscles to the heel and is subject to heavy strain during movement. If it is overloaded, this can lead to pain, irritation and inflammation. We have tips for preventing and treating achillodynia. 

Woman with Achilles tendon pain due to achillodynia

Quickly on the topic:

What is Achillodynia?

Achillodynia is the medical term for pain in the Achilles tendon. It is also referred to as pain syndrome affecting the Achilles tendon (tendo calcaneus or tendo Achillis). Achillodynia refers to the Achilles tendon itself as well as the areas around the Achilles tendon, for example the attachment point on the heel and the surrounding tissue.  

The duration of achillodynia depends on the severity of the symptoms. In mild cases and with early, appropriate treatment, the symptoms can subside within a few weeks or months. Under certain circumstances, however, achillodynia can become chronic. 

Causes of Achillodynia

Achillodynia is usually caused by overloading the Achilles tendon. It is the strongest tendon in the human body and transfers the force from the calf muscles to the foot.

For example, high loads caused by running or jumping can overstress the Achilles tendon and lead to pain, irritation or inflammation. Imbalances in the musculature can also lead to excessive strain on the Achilles tendon and favour the development of Achilles tendinitis. Certain anatomical features such as foot misalignments, an abnormal leg axis or a shortened Achilles tendon can increase the strain on the tendon and the risk of Achillodynia. Rheumatism can also be a cause of Achillodynia. Finally, the elasticity of the tendons decreases with age, which can lead to achillodynia more quickly.  

How can Achillodynia be prevented?

  • You should always carry out an appropriate 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 flexibility and reduce the strain on the Achilles tendon. 
  • When exercising, avoid excessive increases in training volume or intensity. The training load should be increased gradually in order to slowly acclimatise the Achilles tendon. Also give the Achilles tendon sufficient time to recover and wear shoes with appropriate stability to reduce the strain. 
  • Being overweight can also put additional strain on the Achilles tendon. A healthy diet, regular exercise and weight control can reduce the risk of Achillodynia. 

Symptoms and signs of Achillodynia

The clinical picture ranges from irritation to inflammation of the Achilles tendon or the surrounding tissue. Initially, the symptoms only occur during exercise and often disappear after warming up. As the disease progresses, the pain persists and the swelling does not go down, even to the point of being unable to walk. In some cases, the tendon can even rupture (Achilles tendon rupture).

Typical symptoms are  

  • Pain: Pain along the inflamed Achilles tendon, which can intensify when the tendon is stressed, for example when walking, running or jumping. The pain can also occur after prolonged rest. 
  • Restricted mobility: With pronounced achillodynia, there may be restricted mobility or a feeling of stiffness in the Achilles tendon, especially after prolonged rest or when getting up in the morning. 
  • Swelling and redness: If the inflammation is more severe, there may be swelling and redness in the area of the Achilles tendon. 
  • Rubbing noises: Some people may experience rubbing noises in the Achilles tendon during movement.

Diagnosis: Recognising Achillodynia

Achillodynia is usually diagnosed through a combination of clinical examination, medical history and imaging techniques. Firstly, a medical history is taken to obtain information about existing symptoms, the duration of symptoms, previous injuries or traumatic events and the patient's activity level. During the subsequent clinical examination, the area around the Achilles tendon is palpated. This involves looking for swelling, redness and localised pressure pain as well as checking the mobility of the foot and ankle. 

In some cases, imaging techniques such as ultrasound or magnetic resonance imaging (MRI) can be used to assess the severity of the inflammation or any structural damage. When making a diagnosis, other possible causes for the symptoms are also considered and ruled out. These include bone fractures, bursitis (inflammation of the bursa), heel spurs, nerve irritation or other tendon injuries. A careful differential diagnosis is important to ensure that the correct treatment is initiated. 

Treating Achillodynia

Achillodynia therapy aims to alleviate pain in the Achilles tendon and promote healing - at the same time, inflammation can be reduced and relapses prevented. Initially, treatment is always conservative, i.e. without surgery. The choice of treatment depends on the severity of the symptoms, the stage of the disease and the individual needs of the patient.

The following methods alleviate 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 recovery.  
  • Physical measures: If necessary, physical measures such as ultrasound treatments, electrotherapy (TENS), transverse frictions (special massages of the affected muscle or tendon fibres), shock wave therapy or acupuncture can be prescribed. 
  • Soft supports: Soft supports can stabilise 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 their shoes on both sides. 
  • Foot orthotics: Special orthopaedic foot orthotics and heel cushions can help to reduce the strain on the Achilles tendon and improve the position of the foot.  
  • Cooling: Mild cold applications with cooling compresses relieve pain and swelling (refrigerator temperature of around 7 degrees). 
  • Warming: A heating pad, hot water bottle or massage with a hot roller (towelling cloth dipped in warm water) promotes blood flow to the tendon insertion. 
  • Medication: Depending on requirements 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. 

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 to accompany therapy for Achillodynia

A balanced muscle system can reduce the strain on the Achilles tendon in the case of Achillodynia and reduce the risk of injury. Special exercises are used to strengthen the calf muscles as well as the foot and lower leg muscles. Everything you need to know about the aim, sequence and dosage of each exercise for Achillodynia

Supports and foot orthotics 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 foot orthotics (e.g. igli Heel or igli Heel Light from medi) can relieve the irritation situation by providing soft bedding along the plantar fascia and supporting the arch of the foot. 

Health personnel will make the diagnosis and can prescribe medical aids, e.g. from medi if necessary.
Your medical retailer will fit them individually for you.