In Greek mythology, Achilles was dipped into the river Styx by the back of his heel. This made him immortal, except for his achilles that didn’t quite make it into the river. The “Achilles’ heel” phrase refers to a weakness in an otherwise strong or powerful person, that eventually leads to their demise. In Achilles’ case, an arrow straight through the achilles.
Now why on earth did we just give you a lesson in Greek mythology on a podiatry page? We are glad you ask because this is our queue to talk about Achilles tendinopathy.
Lets start with the Achilles it self. The Achilles is the strongest and largest tendon in the body. It attaches the gastrocnemius and the soleus muscles which form the calf to the back of the calcaneus or the heel bone. Insertional achilles tendinopathy is the inflammation of the tendon where it inserts onto the bone. Mid portion achillies tendinopathy is located above the insertion but is not due to an inflammatory response. It is attributed to overuse causing the disorganisation of the collagen fibers in the tendon. Although both insertional and mid portion tendinopathy affect the achilles tendon, both of them have different treatment plans.
Insertional achilles tendinopathy pain will be located over the insertion site on the calcaneus. Thickening of the tendon may be present as well as heat or swelling due to inflammation. Pain can be felt when your start walking and then reduce when it warms up. Treatment for this can include rest and heel raises to reduce the tensile load on the achillies tenon itself. Stretching of the calf muscle is also a must.
Mid portion achilles tendinopathy will tend to hit the people who have had years of running under their belt who have changed up something in their training of have had a change in footwear. This version of tendinopathy has a similar presentation to insertional tendinopathy with the exception of the pain location and the inflammation. Treatment for requires a more comprehensive management program including heel lifts, footwear reviews and a specialised stretching and strengthening program known as the Alfredson technique.
So if you achilles pain is infact your “achilles heel”, do not begrudge the River Styx, come in and have a chat to the team at Perfect Stride Podiatry so that we can get you back into your Perfect Stride.