Summary
Achillodynia is a very common disorder that mainly affects younger athletes. The reason is mostly degenerative changes in and around the Achilles tendon with associated moderate to severe pain, especially during movement. A distinction is made between primary and secondary courses: inflammatory changes are more likely to speak against Achillodynia.
Stage-dependent symptoms can be found: Diagnostically, the patient is first asked about the occurrence, time and type of sport practiced. This is followed by palpation of the Achilles tendon. Ultrasound is used as an imaging diagnosis, which can reveal degenerative changes and vascular infiltrations in the area of the Achilles tendon.
An x-ray usually shows the Achilles tendon only if it is severely calcified. However, degenerative changes in the area surrounding the Achilles tendon and fractures can be ruled out. In rare cases, magnetic resonance imaging should be performed, in which muscle, tendon and bone can be depicted more precisely.
An Achillodynia is treated exclusively conservatively. Initially, the practice of the sport causing the injury should be restricted. The footwear should be checked and, if necessary, treated with insoles.
Furthermore, the blood supply should be ensured by keeping the foot warm. The conservative therapy is rounded off by physiotherapy with stimulation current and cold applications. The success rate is 70-80%.
- Secondary forms of progression include diseases that change the environment or anatomy in the area of the Achilles tendon and thus lead to increased friction. These include situations after surgery, inflammation of the bursae, injuries to the joints and fractures of the upper ankle joint. – The primary form of the disease is usually of a degenerative nature.
- In the initial stage, the patient usually feels a starting pain, which, however, subsides with longer movement. Pressure pain in the area of the Achilles tendon is also in the initial stage of an Achillodynia. – In an advanced stage, the pain is permanent and at rest. In addition, the Achilles tendon swells edematously (swelling with water retention) and can be felt as a thickened area over the heel bone.
