Expert Interview - Podiatrist on Achilles Pain
Sports podiatrist Ian Sadler talks about the biomechanics of achilles tendon pain.
The achilles tendon is formed from the Gastrocnemius and Soleus muscles which joint together and attach to the back of the heel.
Finding which type of achilles pain you have really determine which type of treatment you should have. There is no 'itis' or inflammation and so it is more accurately called tendinopathy which is caused by a traction force on the tendon.
One of the most common is a swelling or nodule about an inch above the heel bone. This is caused by a tractional force from the knee downwards which can damage the tendon. The tendon is always about 20% damaged so it is always in a cycle of repair. If you do the wrong or too much exercise, you start to preduce a less elastic material to repair it, which results in the nodule. The inflammation may come later once the nodule irritates the soft tissues.
Achilles pain can be inflammatory, such as bursitis or nerve injuries. Crucially, people will often use a heel lift for treatment, although with nodules, this won't help. Also, pain on the top of the attachment point is actually compressional rather than tractional and so again a heel raise won't help.
