Achilles tenson pain

Definition:
Achilles tendon pain refers to discomfort arising from the Achilles tendon, which connects the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). It can result from overuse, degeneration, or inflammation.

• Overuse injuries (especially in runners, jumpers, or athletes)
• Sudden increase in activity level
• Tight calf muscles or limited ankle dorsiflexion
• Poor footwear or improper training techniques
• Flatfoot or abnormal gait mechanics
• Fluoroquinolone or corticosteroid use (less common but known risk factors)

1. Achilles Tendinitis
   
   • Acute inflammation of the tendon
   • Usually reversible with conservative care
   • Pain often just above the heel, worsens with activity

1. Achilles Tendinosis
   
   • Chronic degeneration without inflammation
   • Presents with thickening, stiffness, and persistent pain
   • Associated with long-standing or recurrent tendinitis

1. Insertional Achilles Tendinopathy
   
   • Pain at the tendon’s attachment to the heel
   • May involve calcific deposits or Haglund deformity

1. Partial or Complete Tendon Tear
   
   • Sudden, sharp pain with weakness or inability to plantarflex
   • Common in weekend athletes or after steroid injections

• Gradual onset of pain and stiffness in the back of the heel
• Morning stiffness or pain at the start of activity
• Swelling or tenderness 2–6 cm above heel (non-insertional)
• Pain with running, jumping, or pushing off
• Thickened or nodular tendon in chronic cases

• Primarily clinical, based on symptoms and physical exam
• Thompson test for suspected rupture (positive = no plantarflexion)
• Imaging:
  
  • Ultrasound: shows tendon thickening, tears, or neovascularization
  • MRI: used to evaluate extent of damage or partial rupture

• Rest / Activity modification Aircast Air Select Walker Brace/Boot
• Achilles Compression Modvel Compression Ankle Sleeve
• Ice therapy Fitomo Ankle Ice Pack Wrap
• NSAIDs (for pain relief in acute tendinitis)
• Orthotics or heel cups 
  • PowerStep Orthotics
  • Spenco Rx Arch Support - Lightweight
  • 240+lbs Heavy Duty High Arch Support
• Calf stretching and eccentric strengthening exercises ProStretch (The Original Calf Stretcher & Foot Rocker!)
• Physical therapy

• Night splint1 / Night splint2 / Night splint3
• Extracorporeal shock wave therapy (ESWT)
• PRP or other biologic injections (for tendinosis)
• Avoid corticosteroid injections due to risk of tendon rupture

• Indicated for failed conservative therapy (>6 months) or partial/complete tears
• Options include debridement, tendon repair, or augmentation

• Most cases respond well to non-operative management within 3–6 months
• Full recovery from surgical intervention may take 6–12 months
• Early and consistent rehab is key to avoiding recurrence