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Achilles Pain – Causes and Treatment

The Achilles tendon is the thick tendon at the back of the ankle. Pain in the Achilles tendon is a common complaint among riders and athletes, even those who do not participate in the exercise.

In general, Achilles pain can be divided into progressive or sudden pain. Sudden pain is usually the result of a tear or rupture of the tendon. Although it is not uncommon, the progressive onset of pain is more common.


The pain develops slowly and gradually Aggravation most often caused by a group of lesions known as tendinopathy. These conditions are degenerative tendon and surrounding paratenon, also known as tendinitis, although this suggests the presence of inflammatory cell biopsies did not present any.

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Other causes of the gradual onset of pain may be Achilles’ disease bursitis or sectioning, although these are less common.

Achilles tendinitis can occur in the central part of the tendon or an insertion point, or fixation of the heel bone. In the middle part of the tendinitis pain is located about 2 inches above the heel bone. Where the insertion is the point of attachment. Other symptoms include:

  • Rigidity in the tendon, especially after periods of rest.
  • The tendon may appear thicker and red compared to the other side.
  • It is soft to the touch the tendon.
  • The pain tends to melt when heated tendon, then wrapped more after exercise.
  • You can feel small pieces in the tendon (nodules).
  • The tendon can “squeak” in the movement.


Treatment for pain caused by Achilles tendinopathy should involve first the rest and application of cold therapy to relieve pain and stimulate blood circulation. When ice is initially applied, there is a decrease in blood flow, however, when removed after 10-15 minutes, there is a massive influx of blood into the area. What is important in Achilles injuries like a tendon has a notoriously low blood flow that can slow healing.

Other treatment methods should include gentle stretching of the muscle of the calf complex, sporting calf muscles and rubbing the tendon. Ultrasound or laser therapy can also be effective. Heels can be placed in the shoes on a temporary basis to help take the strain out of the tendon. However, wearing this long term can lead to the reduction of the tendon.

Once the initial pain subsided, an eccentric build program can be implemented. Eccentric exercises involve contracting the muscle as a stretch (as opposed to concentric – which shortens). This type of exercise has been shown to be more effective in treating Achilles tendinopathy. The Jump Heel Exercise is the gold standard here, performed in one step, starting with the toes and heels lowering you are slowly under full control until the heel is below the stage level.

As the pain decreases, a gradual return to the sport can be implemented but it is important to ensure that all factors that may have contributed to the development of the lesion are fixed before returning. Common etiologic factors include tight or weak calf muscles, pronation, a sudden increase in activity, hill running and wearing high heels regularly.

For more information about Achilles pain, you can learn more at New York Dynamic Neuromuscula Rehabilitation and Physical Therapy via https://nydnrehab.com/sports-medicine/sports-injuries/achilles-tendinopathy-treatment/.

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