The Achilles is the largest tendon in the human body
Achilles Tendonitis can fall into two catagories. They are mid portion (middle of the tendon) and insertional (more towards the heel bone). With both types having slightly different but also similar symptoms. With mid portion Achilles Tendon Pain, squeezing the tendon can be uncomfortable and in some cases there may be area of swelling. People suffering with Insertional Achilles symptoms can feel a sharp stabbing pain on the back of the heel. This may also be irritated by footwear rubbing on the heel.
Other things you might feel for both mid tendon and insertion can be stiffness in the morning, pain jumping or running and pain going up and down stairs or hills.
When the amount of work the tendon has to do is more than its capacity, injury can occur. An increase in a certain activity like running, sport training or simply a new job or walking more is enough to cause Achilles Pain. Some other contributing causes can be muscle weakness, foot function, footwear, BMI and morbidities like diabetes and Rheumatism.
Finding the exercise that aggravates the tendon pain and reducing it or changing it is good start. Then we look at what biomechanically might be leading to the pain and finding was to improve your functional movement. This can be done through footwear changes/modification or foot orthoses to help unload the stressed tendon. For pain relief in the short term tapping, massage, mobilisation and dry needling can be useful. In most cases you will need to start an exercise program targeting the tendon itself. There is a lot of research evidence on high load strength training to promote healing and prevent future injury. In some chronic cases, shockwave therapy is an appropriate form of treatment.
Management for insertional and mid Achilles pain can be different so it is important to get an accurate diagnosis.