achilles
About the Achilles Tendon
The Achilles tendon is the largest tendon within the body, it attaches the calf muscles to the heel bone. It is a very powerful structure that load up to 12-13 times the bodies weight during running.

It is crucial for walking and running as during the propulsive (toe off) phase of gait (walking) as the calf muscles contract (tighten) to drive the body forward the Achilles tendons pulls on its attachment site, the heel bone, to create heel lift and ankle joint movement.

Achilles Tendon Issues
Achilles problems can present in various ways with the most common site being the mid-portion of the tendon, which affects the middle section of the tendon 2-6cm up from the heel bone. Presentation is characterised by pain and swelling, this can affect walking especially during the push off phase and climbing stairs. The Achilles may feel stiff first thing in the morning and after periods of rest.

Other types of Achilles tendon problems include Insertional Achilles tendinopathy where by the attachment of the Achilles becomes painful and swollen.

foot in propulsion compressed

Common Causes
  • Age and Sex

    Achilles Tendinopathy is more prevalent in middle age runners especially in men

  • Increased Body Mass Index

    An increased body mass places more stress through the tendon during walking & running, which has been estimated up to 12-13 times the body during running.

  • Tight Muscles

    Tight calf muscles will create an increased pull & stress through the Achilles tendon.

  • Flat or Pronated Foot Type

    a rolled in or overly pronated foot type can place more stress on the tendon.

  • Training Issues

    A sudden increase in intensity, distance & poor footwear cam place more stress through the tendon, very common in marathon runners when training.

  • Lower Back Pain

    research has shown a link between sciatica and Achilles problems.

Diagnosis
A diagnosis is made generally from symptoms and clinical assessment, there is commonly localised swelling within the tendon, Imaging such as an Ultrasound is commonly used to aid diagnosis and assess the structures integrity for tears or splits or even rupture so appropriate treatment planning can be commenced.
Treatments

These are presentation dependent and will be tailored following assessment, but may include;

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