What is the Achilles tendon?
The Achilles tendon is the strongest and thickest tendon in the body. The role of the tendon is to transfer the power of the calf muscles to the foot. The tendon in general has a low blood supply and the mid-section of the tendon for this reason, in particular, is most susceptible to injury. The load on the Achilles can go up to 7 x the body weight during running, and up to approximately 4 x the body weight during walking.
Achilles tendon injury
Pain from the insertion point on the heel, up to 6 cm into the calf, represents symptoms of Achilles tendon injury.
The Achilles tendon can suffer inflammatory changes (Achilles tendonitis) but most problems are attributable to degenerative changes in the tendon (Achilles tendonosis) rather than inflammation.
Factors that may lead to Achilles injury include:-
- Poor foot stability and ankle inversion/eversion control
- Incorrect gait
- Hill or uneven terrain running
- Improper footwear
- Over-pronation or over-supination
- Genetic foot alignment issues
The diagnosis of the Achilles problem requires a full assessment of the pelvis and lower limb and observation of the foot during gait. Treatment for the injury revolves around variable such as the stage of the injury (acute or chronic), biomechanical factors (e.g gait), foot position, age and activity levels.
The flowchart below demonstrates the principles for the management of various forms of Achilles tendon injury.