Pain in the Achilles heel - simply explained.
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Pain in the Achilles heel (achillodynia or inflammation of the Achilles tendon)

Achillodynia – description

This condition is the medical term for a painful Achilles heel. The foot acts as a lever when walking. The Achilles tendon is the central tendon in the calf, and its purpose is to build up this leverage. This, in turn, results in this tendon being put under heavy strain. Consequently, the Achilles heel represents a neuralgic spot for many people. This is often reflected as a pressure pain at the base of the Achilles heel as well as a reddening, bulging or swelling of the tendon. Pain is then felt when the tendon is put under pressure, and stiffness often occurs in the mornings.

 

Causes of Achillodynia

The causes of Achillodynia can mainly be put down to malposition of the foot (e.g. Skewfoot or Hallux Rigidus) and/or wearing the wrong type of shoes. The latter cause denotes shoes which do not provide the foot with any support, are too softly padded or which do not compensate a bad posture. Pain in the Achilles heel can also be caused by wearing heels which are too high, if the design of the heel is too protrusive (raising the lever, intensifying the load), if the soles in the forefoot are too hard (interfering with the natural rolling movement of the foot and thereby intensifying the load arm) or as a result of changes in the calf muscles (shortening, hardening or weakening). Abnormal pressure can then cause Paratenditis or an inflammatory irritation of the enthesis on the heel bone. A less common cause is too much pressure caused by sport, resulting in an inflammation of the Achilles heel, for example from long-distance jogging by someone who does not run often (especially forefoot running).

Achillodynia - Prophylaxis

The key to avoiding problems with the Achilles heel is good footwear which fits well. What exactly counts as “good” footwear? Shoes which offer the perfect fit. They are not padded too softly and they provide support to the foot, they are neither too tight nor too wide, and they have (very important) a flexible sole in the forefoot area, which supports the roll-through motion. Try the sole test for yourself: if you bend the shoe, i.e. bend the toe section towards the lacing area, and the soles form into a U shape or V shape, then the shoes have exemplary flexibility.

You must combine the right shoes with focussed training: exercise your foot muscles and Achilles heel with regular exercises. Exercises for the Achilles’ heel primarily serve the purpose of restoring/increasing flexibility and mobility. Many people find that their Achilles’ heel has shortened due to excessive sitting or bad posture. There are many great exercises, which are easy to do, and can be found on YouTube or other internet sites if you search the term “spiral therapy”.

 

Achillodynia - treatment

In the acute stages, treatment can include using a heel wedge to shorten the Achilles tendon and relieve tension. This, however, is only recommended for acute cases and is a short-term solution to avoid the tendon shortening even further. Supportive bandages, friction massages and anti-inflammatory drugs can also be used as methods of treatment. In physiotherapeutic terms, the treatment always involves lengthening the calf muscles, then strengthening them along with the foot muscles and finally improving the muscular coordination and stability of the foot.

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