What is the Achilles Tendon
The Achilles is the tendon that attaches the muscles of the gastrocneumius (calf) and soleus to the back of the calcaneus (heel).
Its main role is to plantarflex the ankle (pointing the foot down) and is responsible for providing most of the force at push off.
What is Midportion Achilles Tendinopathy
Midportion Achilles Tendinopathy is a chronic overuse injury of the midportion of the Achilles Tendon (the midportion of the Achilles is located 2-3cm above the heel)
People with this problem generally present with pain when first getting out of bed which reduces slightly after walking a short distance and then returns again with extended walking.
It is also a common feature that there may be a nodule in the middle of the Achilles tendon- this occurs when there is a fat build up within the tendon and will present as a palpable nodule
Causes of Midportion Achilles Tendinopathy
The Achilles Tendon is made up of collagen fibres which are similar to a rope.
Mid portion Achilles tendinopathy involves chronic degeneration at the mid portion of the Achilles tendon.
Certain factors are though to increase the risk for the development of Midportion Achilles Tendinopathy including:
- Certain medications (Fluoroquinolones – ciprofloxacin)
- Non- Supportive footwear
- Flat arched feet
- High arched feet
- Sudden increase in activity
- Being overweight
- Hormone problems (Reduced Thyroid function, Menopause)
- Connective tissue disorders (Rheumatoid arthritis)
Diagnosis of Midportion Achilles Tendinopathy
Diagnosis is generally made with specific signs and symptoms – when the pain occurs and the location.
At the Ankle, Foot and Orthotic Centre we are able to provide additional information about the presence of Midportion Achilles Tendinopathy with ultrasound imaging.
Typically someone with midportion Achilles will have a thicker disorganised midportion area in the midportion of the Achilles shown in the picture below.
Treatment of Midportion Achilles Tendinopathy
Treatment aims to reduce the disorganisation of the connective tissue in the Achilles tendon and also minimise the risk factors for re-injury. This can include
- Shockwave therapy
- Orthotic correction
- Stretching Alfredson Eccentric Stretches
- Home Massage techniques
- Night Splinting
What else could it be? (differential diagnosis)
Other problems that can cause similar pain to a neuroma include:
Kagers Fat Pad Inflammation
Tarsal Tunnel Syndrome
Tibialis posterior tendon dysfunction
Expert Podiatrists and Orthotists in the treatment of Achilles problems servicing the areas of Northcote, Thornbury, Fitzroy, North Fitzroy, Carlton, North Carlton, Alphington, Fairfield, Brunswick, Coburg and Preston
Call The Ankle, Foot and Orthotic Centre in Northcote for further advice on professional management and treatment options.