Achilles problems in runners are very common, particularly in distance runners. The Achilles is the most powerful tendon in the body required to absorb energy on landing and produce a propulsive force to push through the ground during take off. The management and treatment of an Achilles issue is dependant on the diagnosis. Achilles pain can be diagnosed based on the location and the structure involved such as Achilles tendinopathy (tendon), Achilles tenosynovitis (tendon cover) or Achilles bursitis (bursa).
Each of these conditions can occur due to intrinsic and extrinsic factors. Identifying the contributing factors is important to determine what has caused excessive loading prior to taking action in how we treat the Achilles pain. Intrinsically we have to look at the way the body functions such as poor strength or tight calf/ankles. Extrinsically we need to look at the potential of training load and foot wear as contributors to leading to Achilles pain.
Achilles tendinopathy is a particularly complex condition as it has multiple stages which produce different symptoms at the time. Symptoms typically have a gradual onset and can include stiffness in the morning and initially with activity that warms up, pain with running, tenderness to touch and there may be a swollen appearance in the Achilles also. In the early stages on this condition, the changes to the Achilles are reversible, later in the condition, the changes can become more permanent. This is why it is important to manage this condition adequately.