Inflammation Achilles tendon

Introduction

With a length of about ten centimeters and a diameter of about one centimeter, the Achilles tendon is the strongest tendon in humans. It can withstand loads of more than 500 kg. The Achilles tendon, known in Latin as tendo calcaneus, transmits the force of the strongest flexor muscle in the upper ankle joint, called musculus triceps surae, to the heel.

The musculus triceps surae is innervated by the so-called tibial nerve, whose function can be examined with the Achilles tendon reflex. Various causes can lead to acute or chronic inflammation of this strong tendon. The most common are mechanical causes, which have their origin in overloading or incorrect loading of the musculature.

Symptoms

The main symptom of an inflammation of the Achilles tendon is severe pain. This pain can have a stabbing character. In the case of a so-called acute inflammation of the Achilles tendon or an acute inflammation of the tendon sheaths surrounding the tendon, strong, often stabbing pain occurs in the area between the calf muscles and the heel, especially during a load.

Often the pain can be detected at the tendon attachment of the heel. This pain can often be triggered and localized by pressure or passive movement. The pain is often accompanied by swelling.

In contrast to an acute inflammation, which usually causes pain only during exertion, a chronic inflammation, on the other hand, leads to a typical initial pain, which is particularly noticeable after lying down, sitting or getting up in the morning. The pain often intensifies when walking uphill. Other known symptoms are pressure pain and hardening of the Achilles tendon.

On the one hand, touching it with the hands can cause pain in the area of the tendon, and on the other hand, it is possible to feel a hardening or thickening of the tendon itself. These hardenings can lead to an audible crunching when moving. Various causes can lead to an acute or chronic inflammation of the strong Achilles tendon.

The most common are mechanical causes that originate from overloading or incorrect loading of the muscles. This occurs mainly during sports. Running fast and uphill puts a particular strain on the Achilles tendon, which has to bear the weight of the entire body during walking.

An inappropriate increase in training intensity as well as too much training in general also lead to severe overexertion of the Achilles tendon. Such overexertion is exacerbated by overweight, which naturally increases the load on the Achilles tendon. However, not only incorrect training, but also incorrect footwear or running on unfavorable ground can cause strain on the Achilles tendon and thus inflammation of the tendon.

Body’s own factors also play a major role in the list of causes. Tension and shortening of the calf muscles or differences in leg length lead to incorrect loading of the muscles and tendons, so that the Achilles tendon can be incorrectly loaded on one side. An anatomical change in the heel, such as in the case of a so-called ganglion, can also lead to considerable incorrect loading and thus damage to the Achilles tendon.

Other causes can be previous injuries to the ankle joint, the musculature or the Achilles tendon itself. An inflammation of the Achilles tendon attachment is often accompanied by bursitis and a heel spur. Such a spur, which develops between the bone of the heel and the Achilles tendon, irritates the Achilles tendon considerably and can lead to a chronic inflammation of the latter.

In addition, various rheumatic diseases can cause Achilles tendon inflammation. A rheumatoid arthritis, which is a chronic inflammatory systemic disease due to an autoimmune reaction of the body, it can lead to the involvement of the Achilles tendon. In particular with the Bechterew’s disease a painful inflammation of the tendon attachment of the Achilles tendon, also called enthesiopathy, is known.

This usually affects women between the ages of 20-40 years. In addition, there is a high familial incidence of this disease. A further cause of Achilles tendon inflammation can be the intake of certain antibiotics.