Pain in the Achilles tendon or pain in the back of the heel may be a condition referred to as Achilles tendonitis or Achilles tendinopathy. This tendon runs from the calf muscles into the back of your heel bone. The pain is as a result of inflammation as a result of micro-tears in the tendon or due to the tendon pulling away at the insertion to the muscle or the heel bone.

There are multiple factors that can give rise to this condition and they include: incorrect footwear, inappropriate stretching before sports or exercise, biomechanical dysfunction, overuse, lack of flexibility or increasing training too much too soon.  

Stiffness and pain in the back of the heel or tendon is usually present and normally presents when starting an exercise or sport (such as running) This often eases as you continue your activity. Redness, warmth and swelling at the back of the heel and a hard, tender bump often develops if this is not treated for an extensive period. As the condition worsens, you may not be able to continue running or exercising due to the pain.

Other structures that can cause pain in the area are Bursae. There are two fluid filled sacks (anatomical Bursae) at the back of your heel to reduce friction around the Achilles tendon. One is located between your heel bone and the tendon and the other is located between the skin and the tendon. These Bursae often become irritated in this condition and result in increased pain and inflammation.

Excessive traction forces from the Achilles tendon may eventually lead to the development of a bony spur at the back of the heel bone.

The tendon does not have a good blood supply and therefore is at risk of re-injury or rupture if not managed correctly. See one of the Podiatrists at Oxford Street Podiatry for more information on Achilles tendonitis. Treatment options may include: orthotics to fix any biomechanical issues, heel raises to decrease the load on the tendon, footwear advice, activity modification, stretching and strengthening programs, joint mobilization, myofascial release, dry needling, barefoot rehabilitation and trigger point therapy.