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Trouble with the Achilles Tendon

By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute

Trouble with the Achilles tendon is often caused by an overload and appears as pain and stiffness in the Achilles tendon. The condition gradually improves by relief, ordinarily; it can take from several days to weeks. You general practitioner can prescribe medication and/or refer to a physiotherapist. In rare cases, an orthopaedic surgeon can perform an operation on the Achilles tendon.

Pain and swelling on the back of the heel and up the Achilles tendon are signs of overload and irritation of the tendon. Both young and elder people can be affected by the condition. With older people, the strength of the Achilles tendon decreases and therefore it is more easily overloaded. With young people the overload arise from a change in the level of activity, wrong footwear, exercise on hard foundation or in a cold climate. Trouble with the Achilles tendon is also often seen with people who are flat-footed.

Typically, the pain starts in connection with the physical activity (e.g. running). The pain decreases some, following a short period of activity and is subsequently worsened. Stiffness in the Achilles tendon appears hours to days after an overload. In advanced cases, it is also painful during rest. The Achilles tendon can feel thickened and sore.

Relief gradually improves the condition; usually it takes from several days to weeks. Through continued overload, a chronic condition develops that can lead to rupture of the Achilles tendon.

What can you do?

Since it is an overload, relief helps. Relief consist of decreased physical activity that is slowly increased while taking into consideration the pain and stiffness in the Achilles tendon. If you experience pain after running for 1 kilometre – well, then you have run too far.

A shock absorbing inlay in the heel of the shoe will relieve the tendon and soothe the pain. When buying running shoes it is important with a shock-absorbing heel, which is cast into many running shoes. Stretching the Achilles tendon before and after exercise is important. It can be performed standing up with a stretched leg where the foot is pressed against a wall, after which you press the stretched leg toward the wall. Stretches must be slow and last 20 to 30 seconds.

Contact the doctor tomorrow

If you have tried relief, shock absorbing inlays and stretching for some weeks without results, you can contact your general practitioner.

A doctor can prescribe medication that is both painkilling and decreases irritation in the Achilles tendon.

In addition to this, you can be referred to physiotherapy where you receive massages and advice concerning physical training. The physical training must be performed on a regular basis, twice a day for seven days a week for up to three months with increasing load. The physiotherapist can also choose to combine physical training with laser treatment.

Contact the doctor immediately

If you, after months of treatment with massage, physical training and laser treatment, continue to be bothered, surgery can be necessary, as an exception.

In the case of chronic nuisances, an operation on the Achilles tendon can be performed. After the operation, a lengthy course of rehabilitation must be completed and not until 3 to 6

months after, competitive sports can be resumed. Around 85% are cured. Because of the long course of rehabilitation, very few choose to have such an operation.