Pain in the area of the Achilles tendon is extremely common, and not only among regular sportsmen. The pain can have many different causes. In general, Achillodynia and inflammation, which are usually an expression of overloading the Achilles tendon, can be distinguished from pain resulting from injuries in the Achilles tendon area, e.g. torn Achilles tendon. A third disorder that can trigger Achilles tendon pain is the heel spur.
Causes for Achilles tendon pain
If it comes to Achilles tendon pain, this is usually due to an inflammation in the Achilles tendon. This inflammation, also called Achillodynia, is very often caused by overloading, especially in athletes. In running and jumping sports, the Achilles tendon is put under much more strain than when walking or standing.
This can lead to micro-cracks, which cause an inflammatory reaction. This is accompanied by pain in the Achilles tendon. Repeated excessive strain can damage the tendon so severely that it is less resilient.
This can lead to a tear of the Achilles tendon. The tendons in the human body are located in so-called tendon sheaths, which guarantee good sliding of the tendons during movements and nourish them by secreting fluid. The metabolism of tendons is not very active, so injuries heal only very slowly.
Overloading and injuries of the Achilles tendon during sports can be prevented by a gentle warm up. Then the tendon sheaths have time to produce more fluid and thus the Achilles tendon glides better during movements. Pain in the Achilles tendon can also be caused by rheumatic diseases. Here an inflammation develops, with which the own immune system is directed against fabric of the tendon sheaths. A frequent rheumatic illness, which accompanies with Achilles tendon pain, is the disease Bechterew.
Associated symptoms of Achilles tendon pain
Achilles tendon pain can be accompanied by other symptoms. The Achilles tendon can thicken in its entire length or only in places. If the pain is due to an upper heel spur, there may be a thickening at the tendon attachment directly above the heel.
If the tendon is already torn, either wholly or partially, it may be necessary to palpate it thinner (partial tear) or to palpate a gap instead of the Achilles tendon, which is an indication of a complete tear of the Achilles tendon. In this case, it is no longer possible to stretch the foot against force. If the pain at the Achilles tendon is due to a rheumatic illness, then numerous other accompanying symptoms can be present, which are also caused by the rheumatic illness.
These are often joint swellings, back pain as well as back and joint stiffness particularly in the morning hours. In the course of the inflammatory reaction, a thickening of the Achilles tendon can occur, which then has to be felt as a knob. With an acute inflammation the Achilles tendon is then painful under pressure.
In addition, a redness and swelling may form around the tendon. It is important in this case that a protection takes place until the symptoms have disappeared again and a pain-free load is possible. In the case of recurrent inflammation, a chronic thickening of the tendon may occur, but this is usually not painful or only slightly painful.
Often pain in the Achilles tendon occurs especially in the morning after getting up. If pain is caused by inflammation, the reason for this is that little fluid is produced in the tendon sheath at night. Since one moves little at night, it is not necessary for the body to expend energy for this.
The inflammation causes adhesions in the tissue. If you take your first steps in the morning after getting up, new fluid must first be produced so that the tendon can glide well. The first movements loosen the adhesions.
This is initially accompanied by pain, which characteristically disappears after some time of movement. If the pain in the Achilles tendon is due to a rheumatic disease, it is also typical that pain occurs especially in the second half of the night and in the morning. This is due to the fact that rheumatic diseases are very active, especially during this time.If a rheumatic illness is present, it comes apart from the Achilles’ tendon pain in addition often still another joint rigidity in other body regions, joint swelling or back pain. The time in the morning, until the pain becomes again less is with approx. one hour also clearly longer than with a usual inflammation.
