Achilles Tendonitis comes in two flavour’s acute and chronic;
Is a gradual onset of achilles pain that develops over days or even hours after exercise at the back of the ankle, stretching above the heel bone. Pain may diminish upon activity/exercise and rest over days the symptoms often fade, until next training session or heavy activity and is then very tender to touch.
Chronic achilles tendonitis may follow on from acute tendonitis if it goes untreated or is not allowed sufficient rest.
A gradual build-up of pain in achilles over a period of weeks, or even months. Pain is experienced while exercising and is constant especially when going uphill or up stair case. Stiffens up overnight, swelling, lumps and bumps soon appear and very painful on touch, heat and redness appear. A click sound may be experienced when moving ankle or running fingers over achilles.
It is estimated that achilles tendonitis accounts for 11% of all running injuries. The Achilles tendon is the large tendon at the back of the ankle. It connects the large calf muscles (Gastrocnemius and Soleus) to the heel bone (calcaneus) and provides the power in the push off phase of the gait cycle (walking and running).
Achilles tendonitis is now being referred to as achilles tendinopathy because it is no longer thought to be an inflammatory condition. The main finding is usually degenerated tissue with a loss of normal fibre structure.
Achilles tendonitis can be either acute, meaning occurring over a period of a few days, following an increase in training, or chronic which occurs over a longer period of time. In addition to being either chronic or acute, the condition can also be either at the attachment point to the heel or in the mid-portion of the tendon (typically around 4cm above the heel). Healing of the achilles tendon is often slow, due to its poor blood supply. Achilles tendonitis is an overuse injury. Too much too soon (hit the running track without adequate preparation is a classic cause). There other factors that can contribute to developing the condition;
Increase in activity (distance, speed or hills). Inadequate recovery and repair change of footwear or training surface or weak calf muscles.
Decreased range of motion at the ankle joint, usually cause by tight calf muscles.
Running up hills - the achilles tendon has to stretch more than normal on every stride. This is fine for a while but will mean the tendon will fatigue sooner than normal.
Overpronation = feet which roll in when running can place an increased strain on the achilles tendon. As the foot rolls in (flattens) the lower leg also rotates inwards which places twisting stresses on the tendon.
Wearing high heels constantly shortens the tendon and calf muscles. When exercising in flat running shoes, the tendon is stretched beyond its normal range which places an 'abnormal' strain on the tendon.