Achilles Tendon Pain

1. Achilles Tendon: An Overview

The Achilles tendon is the strongest tendon in our body¹⁾— just as the Greek hero of mythology was the strongest among all warriors. That’s not the only similarity both share, however. Like Achilles’ heel was his weak spot, so is the tendon for us. 

The Achilles tendon is a band of tissue that connects the muscles in the calf to the heel bone. It allows us to lift the heel off the ground while walking, jumping, or running.

Although built to endure massive amounts of stress, the Achilles tendon is not immune to wear and tear as well as other damage. Not surprising then that it is one of the “most frequently injured tendons in the human body.”²⁾

2. Causes for Achilles Tendon Pain

Most conditions and injuries of the Achilles tendon link back to extreme tension on the tendon, often caused by overusing or even underusing the muscles and fasciae connected to it.

Liebscher & Bracht discovered that due to the connection between the leg musculature and the Achilles tendon, any overloading of the muscles transfers to the tendon itself, subsequently increasing musculofascial tensions. This means that the Achilles tendon is victim to constant tension thanks to the pull of overloaded and/or musculofascial shortened calf and shin muscles. If this tension persists, the brain will send a so-called signal pain into the affected area. This pain serves as a warning to stop any stressful movements to prevent further damage to the tendon. To relieve the pain, we recommend exercises to normalize musculofascial tensions. You’ll find a selection in our exercise article.

Achilles tendon injuries due to extraordinary load on the tendon are especially prevalent in any physical activity that involves running, jumping, and turning quickly.³⁾

Particularly individuals who are not used to athletic sports are at risk since the unfamiliar movements put extra amounts of stress on the untrained and underused leg muscles and thus the Achilles tendon. 

Additionally, sudden increase or intensifying of physical training and training errors pose additional risks for the Achilles tendon to get damaged or, in the worst case, ruptured.⁴⁾

Further, there are extrinsic factors to keep in mind. Wearing certain types of shoes or exercising on uneven terrains can affect the Achilles tendon negatively in the long term, too. The same counts for medication, such as cortisone or immunosuppressive drugs. In the worst case, continuous consumption of these can lead to tendinosis. Lastly, food additives like MSG (monosodium glutamate) have been identified as pain intensifiers. Scientists found a significant glutamate concentration in the Achilles tendons of chronic pain patients.⁵⁾

Besides these, intrinsic factors such as anatomical characteristics (e.g., pronation of the foot or a decreased blood supply) can play a role in the surfacing of Achilles tendon pain. 

3. Symptoms of Achilles Tendon Pain

Depending on what type of condition causes the pain, different symptoms may occur. 

• Irritations happen infrequently and are situational. If the pain persists, the Achilles tendon might become inflamed. 
• Inflammations (e.g., Achilles tendonitis or Achilles peritendinitis) may be accompanied by stiffness, throbbing pain, and a thickening of the tendon. Movement may be limited. The skin over the tendon might feel hot to the touch.
• Tendon tears are usually characterized by a throbbing ache and swelling, often appearing all of a sudden or over time. Due to the pain, movements might be difficult and/or impaired. 
• Ruptures happen suddenly, often not even preceded by any symptoms. Once the tendon snaps with an audible popping sound, sharp pain may set in. Swellings of the foot and leg are not uncommon either.
• Fluid sacs (bursa) cause the heel to swell and redden. It also may feel warmer than other body parts and hurts when touched. Sharp pain that increases when you bend the foot.

4. How to Treat Your Aching Achilles Tendon

In most cases, conditions related to the Achilles tendon can be treated non-operatively and without medication. A mixture of exercise and behavioral modifications (e.g., addressing training errors, wearing appropriate gear, and changing the diet) is a good way to remedy Achilles tendon issues.⁶⁾ Additionally, hot and cold application treatments are deemed useful to a degree.

Mainstream medicine also recommends the usage of pain relievers, ranging from over-the-counter drugs to prescribed medication. This will only lessen the pain temporarily, however, and merely masks the symptoms.

We use three techniques to soothe and prevent pain: 

• muscle-fasciae stretches, 
• foam rolling massages, 
• and osteopressure. 

The stretches help you to stay mobile and flexible. The foam rolling unravels your tangled fasciae so that the interstitial fluid can flow freely through the extracellular space inside your body. The osteopressure is known to reduce pain instantly by pressing specific points on your bones. Doing this resets the brain programs responsible for painful sensations. Should you be unable to exercise because the pain is too great, we recommend performing this technique before you start stretching or foam rolling. 

A worst-case option to treat Achilles tendon ruptures, and the likes, is surgery. However, the merits of such an operation could not yet be proven.⁷⁾ Surgical treatment always poses the risk of being ineffective, possibly worsening the condition, or leading to further complications and issues.