Diseases: Inflammation of the Achilles heel

Inflammations in the area of the Achilles heel can have different origins. A distinction is made between inflammation of the Achilles tendon (tendinitis) and inflammation of the Achilles tendon sheath (tendovaginitis). Inflammations of the tendon often develop at the bottom of an (age-related) degeneration.

The typical signs are pressure pain and pain under stress. In this case, the pain arises when walking and especially when standing on tiptoe. The diagnosis is usually made by means of an ultrasound examination or magnetic resonance imaging.

If the findings are unclear, an arthroscopy can also be performed. In mild cases, the therapy of choice consists of non-steroidal anti-inflammatory drugs and physiotherapy. In the case of severe courses or persistent inflammation, surgical measures can be considered.

Inflammations can also affect the bursa of the Achilles tendon (bursitis subachillae). Such inflammations often occur after trauma, recurrent incorrect strain and infections. Such inflammations often manifest themselves through pain, swelling and/or overheating of the affected area.

If the inflammation is caused by bacteria, antibiotics can be used in addition to non-steroidal anti-inflammatory treatment. To reduce the pain, the area can also be punctured to allow secretion to drain away. Another form of inflammation is bone inflammation (osteomyelitis). This type of inflammation usually occurs after a bone fracture or bone surgery. In such cases, in addition to antibiotic therapy, the affected bone must usually be removed or replaced.

Diseases: posterior heel spur

The heel spur is a bone formation in the area of the heel. This new formation is often spur-shaped and can lead to discomfort when walking and pain. Such a new formation is observed especially in overweight persons or people who have to stand for a long time (due to their job).

A heel spur does not necessarily cause discomfort. Only when the piece of bone affects the surrounding structures does it cause pain. Inflammations of the bursa tendinis calcanei (bursa between Achilles heel and Achilles tendon) are often wrongly diagnosed as heel spur.

The simplest and quickest method to diagnose the heel spur is an x-ray of the lateral foot. Various therapeutic approaches can be used to treat symptoms. As a rule, a combination of painkillers and adequate insoles are preferred. Additionally, physiotherapy and cryotherapy can be prescribed. If the therapy is unsuccessful, one can try to destroy the heel spur with the help of shock waves or even consider surgical treatment.

Disorder: Strain of the Achilles heel

Pulling the Achilles heel is not possible per se because it is a bone. However, a pulled Achilles tendon can occur in this area. In this case it is an overstretching of the muscle as a result of trauma or incorrect movement.

Strains of the Achilles tendon can occur primarily during sporting activities with alternating foot movements (such as football, rugby, tennis, etc.). Here the muscle is either over- or incorrectly strained. A muscle strain is characterized by pain when tensing or loading, but not when stretching the muscle.

If a muscle strain is suspected, the muscle should first be protected and cooled. A (pressure) bandage as well as a high position can help in the further course. In general, the PECH rule applies: rest, ice, compression, high position. If the complaints worsen or have been existing for more than a week without improvement, a doctor should be consulted. Strained muscles can be avoided by warming up before exercise.