Mid-Portion Achilles Tendinopathy

The Achilles tendon is the largest and strongest tendon in the body. It links calf muscles to the back of your heel bone and plays a vital role in walking, running and jumping. In short, it handles forces of up to twelve times the whole body weight during high-impact movements. However, excessive strain can lead to mid-portion Achilles tendinopathy. This condition makes simple activities like climbing stairs or standing on toes painful and, in extreme cases, debilitating.

Mid-portion Achilles tendinopathy occurs 20mm to 60mm above the tendon’s insertion point. The pain is mostly felt along the cord-like structure of the tendon, and can be elicited by pinching it. Mid-portion tendinopathy is primarily a tensile loading issue, frequently associated with chronic degeneration from repetitive strain.

Causes of Achilles Tendinopathy

Mid-portion Achilles tendinopathy stems from either overuse injuries or gradual deterioration of the tendon. When subjected to excessive force beyond its tolerance, the tendon can develop micro-tears or, in severe cases, partial or complete ruptures.

Common risk factors comprise:

Running at higher speeds or distances than usual
Sudden increases in training intensity without proper adaptation
Tight calf muscles that add pressure to the tendon
Wearing unsupportive or low-heeled footwear
Foot biomechanics that create excessive strain
Participating in high-impact sports like basketball or volleyball

Ignoring early warning signs—such as dull aches at the back of the heel—can lead to worsening damage and persistent pain.

Home Remedies

While professional treatment is recommended, you can take steps at home to manage your symptoms until you see a podiatrist:

Apply ice to the back of the heel for at least 15 minutes at a time, and ensure the ice is wrapped in a towel in order to protect the skin.
Use anti-inflammatory medication to help reduce pain and swelling.
Incorporate gentle walking if tolerated. Progressive loading can help maintain tendon function without overexerting it.
Wear supportive footwear with a slight heel to reduce tension on the Achilles tendon.
Use orthotics if you already have them, and they help provide relief.

Medical Treatment Options

If you’re experiencing persistent mid-portion Achilles tendinopathy, a podiatrist will conduct a comprehensive assessment to diagnose the specific cause of your discomfort. A personalised treatment plan may include:

Heel lifts: In-shoe inserts that reduce strain on the tendon while allowing mobility.
Custom orthotics: Designed to optimise foot positioning as well as alleviate excessive tendon strain.
Stretching and strengthening programs: Addressing tight calf muscles, muscle imbalances and gradual tendon strengthening to aid recovery.
Footwear modifications: Ensuring proper support to promote healing and prevent further strain.
Immobilisation (if necessary): A moon boot or CAM walker may be required so as to promote recovery in severe cases involving significant tears or ruptures.

Summary

Mid-portion Achilles tendinopathy can significantly impact your mobility and quality of life. Early intervention is important in preventing more damage and ensuring a smooth recovery. So, if you are experiencing symptoms, consult a podiatrist or doctor to receive expert care tailored to your needs.