Achilles paratendonitis is characterised by inflammation and thickening of the sheath surrounding the Achilles tendon.
On palpation and ultrasound assessment of the paratendon, swelling, crepitus and discomfort can be detected.
Signs & Symptoms Copy
Achilles tendinopathy is an overuse condition characterized by gradual onset of pain in the Achilles.
This is the largest tendon in the body. It attaches the calf muscles in the lower leg to the back of the heel (Calcaneus). There are two calf muscles, the Gastrocnemius and Soleus. These strong muscles allow us to rise up on our toes making them prime muscles used in walking and running.
Pain is usually worse in the morning and eases with heat and exercise. Pain reappears a few hours after physical activity.
What Causes It?
Over pronation of the feet
Tight calf muscles
Poor tensile strength through the tendon and calf muscles
Hypomobile ankle and subtalar joints
Overtraining or change in intensity, duration, frequency
Incorrect or poor footwear
Previous Achilles strain or rupture
How to Self Manage
Implement the R.I.C.E. protocol to reduce pain and swelling
Modify aggravating activities
Stretch calf muscles
This condition requires prompt management, as the tendon can remain thick and inflamed. This then has the potential to progress into a more degenerative condition referred to as Achilles Tendinopathy
How Physio Helps
Review and modification of training program
Soft tissue massage
Deep transverse frictions
Taping to offload the tendon
Prescription of a heel raise to offload the tendon