Achilles Tendonitis Causes, Symptoms, and Diagnosis - It All Hangs Together

Published 2023-06-04
Getting a diagnosis of Achilles tendonitis right depends to a large extent on listening to the patient to understand what caused their heel pain and deciding whether this as well as the symptoms fit this type of injury. Treat My Achilles co-founder Maryke Louw takes us through the typical causes of Achilles tendonitis, the symptoms to look out for, and the steps we use to arrive at an accurate diagnosis.

šŸŒŸNeed more help with your injury? Youā€™re welcome to consult one of the team at TMA via video call for an assessment of your Achilles injury and a tailored treatment plan: www.treatmyachilles.com/

šŸ“½ļøOther videos mentioned in this video:
ā–¶ļø How Fluoroquinolone Antibiotics Cause Achilles Tendonitis and Achilles Tears: Ā Ā Ā ā€¢Ā HowĀ FluoroquinoloneĀ AntibioticsĀ Cause...Ā Ā 
ā–¶ļø Antibiotic (Cipro) Induced Achilles Tendonitis Treatment: Ā Ā Ā ā€¢Ā AntibioticĀ (Cipro)Ā InducedĀ AchillesĀ T...Ā Ā 
ā–¶ļø Learn how the Menopause can Cause Achilles Tendonitis: Ā Ā Ā ā€¢Ā LearnĀ howĀ theĀ MenopauseĀ canĀ CauseĀ Ach...Ā Ā 
ā–¶ļø Got Hit In The Achilles Tendon? How To Treat It: Ā Ā Ā ā€¢Ā GotĀ HitĀ InĀ TheĀ AchillesĀ Tendon?Ā HowĀ T...Ā Ā 
ā–¶ļø How Statins Can Cause Achilles Injuries: Ā Ā Ā ā€¢Ā HowĀ StatinsĀ CanĀ CauseĀ AchillesĀ InjuriesĀ Ā 
ā–¶ļø Haglund's Deformity Treatment: Ā Ā Ā ā€¢Ā Haglund'sĀ DeformityĀ TreatmentĀ Ā 
ā–¶ļø How Neural Tension can Cause Achilles Tendinopathy: Ā Ā Ā ā€¢Ā HowĀ NeuralĀ TensionĀ canĀ CauseĀ Achilles...Ā Ā 
ā–¶ļø Top Tips for Insertional Achilles Tendinopathy: Ā Ā Ā ā€¢Ā TopĀ TipsĀ forĀ InsertionalĀ AchillesĀ Ten...Ā Ā 
ā–¶ļø Tingling Heel & Achilles - Causes & Treatment: Ā Ā Ā ā€¢Ā TinglingĀ HeelĀ &Ā AchillesĀ -Ā CausesĀ &Ā T...Ā Ā 
ā–¶ļø Treatment Options for Achilles Tendonitis: Ā Ā Ā ā€¢Ā AchillesĀ TendonitisĀ TreatmentsĀ -Ā TheĀ ...Ā Ā 
ā–¶ļø Rehab Exercises for Achilles Tendonitis and How to Progress Them: Ā Ā Ā ā€¢Ā ExercisesĀ ForĀ AchillesĀ Tendonitis/Ten...Ā Ā 

šŸ“šChapters:
00:00:00 Introduction
00:00:33 Where is the Achilles tendon and what does it do?
00:01:53 What causes Achilles tendonitis?
00:13:40 Achilles tendonitis symptoms
00:23:38 How to diagnose Achilles tendonitis
00:30:04 How we can help

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References:
Cook JL, Rio E, Purdam CR, et al. ā€œRevisiting the continuum model of tendon pathology: what is its merit in clinical practice and research?ā€ British Journal of Sports Medicine 2016;50:1187-1191.

De Vos, R.-J., et al. (2021). "Dutch multidisciplinary guideline on Achilles tendinopathy." British Journal of Sports Medicine 55(20): 1125-1134.

Hanlon, S. L., et al. (2021). "Beyond the Diagnosis: Using Patient Characteristics and Domains of Tendon Health to Identify Latent Subgroups of Achilles Tendinopathy." J Orthop Sports Phys Ther 51(9): 440-448.

Hutchison, A. M., Evans, R., Bodger, O., Pallister, I., Topliss, C., Williams, P., & Beard, D. (2013). ā€œWhat is the best clinical test for Achilles tendinopathy?ā€ Foot and Ankle Surgery, 19(2), 112-117.
Tu, P. (2018). "Heel pain: diagnosis and management." American Family Physician 97(2):86-93.

Khan KM, Forster BB, Robinson J, et al. ā€œAre ultrasound and magnetic resonance imaging of value in assessment of Achilles tendon disorders? A two year prospective study.ā€ British Journal of Sports Medicine 2003;37:149-153.

Longo, U. G., Ronga, M., & Maffulli, N. (2018). ā€œAchilles tendinopathy.ā€ Sports Medicine and Arthroscopy Review, 26(1), 16-30.

Malliaras, P. (2022). "Physiotherapy management of Achilles tendinopathy." Journal of Physiotherapy. 68 (4), 221-237.

Scott A, Docking S, Vicenzino B, et al. ā€œSports and exercise-related tendinopathies: a review of selected topical issues by participants of the second International Scientific Tendinopathy Symposium (ISTS) Vancouver 2012. British Journal of Sports Medicine 2013;47:536

All Comments (21)
  • @reggiepoonyane5260
    Thank you for the wholesome info. That is my condition with the injury esp on left foot. You have diagnosed with exactness and have analysed it. It s true the pain starts and forces a stop on my 10 k jog run when i m left with 2 & 1/2 kilometres to go.This occurs every time I'm about to finish I walk a long 8k to work & back, 3 times a week and do a jog on this 2 days in the week plus on Sat & Sun Perhaps is too much walking to work??? I thought the walk was supplementing my running ā¤ TY
  • @ElijahXMedia
    Yea I have insertional ā€¦got it after playing a lot of basketball after being inactive, been sore for a month.
  • 20:04 amazing explanation. I am suffering from exactly this and had to stop playing tennis because I am afraid of a tearing up. 21:11 I am looking for a solution and found your so helpful videos.
  • @mexdrago3009
    Mine is insertional and pain travels to the heel which may seem like plantar fasciitis. What your explaining sound exactly what's wrong me all these years. Im always offered insoles and they get it wrong no matter how well I explain where my pain is. Podiatrists seem to not listen to me. Are orthodontist better?
  • Thank you for all this content. I saw an Orthopedic doctor and did an ultrasound and an xray and they are saying tendonitis. Had no ā€œouchā€ moment just started aching and increased slowly. But I got a ton of swelling in my ankle on the opposite side of where the tendon hurt the most, and my entire foot and ankle was super swollen so I was surprised to hear not much swelling. Also I got a roughly golf ball sized purple bruise over by the tendon. So again surprised to hear you say no bruising. A little confused now! But it definitely hurts most smack dab in the middle of my tendon/ankle. Not high or low.
  • @kellyfisher1868
    Great video thank you. I am presenting with tendonitis in the right foot and after a few weeks it has moved to the left foot. I dont do any strenuous or intense exercises but have recently increased stretching and strengthening glute/hamstring muscles as a way to reduce piriformas pain. Is there any correlation with the stretching / piriformas as its close to sciatica? Ive also noticed a bersa on the left foot. How does treatment differ with a bersa? Thanks!
  • @Bands_and_Bells
    That was a great video with very helpful information. I was attempting to diagnose the pain I have been feeling and there was no difference between pinching the Achilles on either side. However when I lightly apply a massage gun (very lightly) to back of the tendon there is a decent amount of pain. Zero pain on the other side. This is an older overuse injury from hiking too much and continues to come back. It fits most of the descriptions for tenonitis, but I'm curious if you think it could be something different given the self diagnosis technique?
  • @Abhiabs
    Hello, I play a few sports in a week (Cricket,Football and Badminton) at least once a week. I had a good 2 hour badminton session on a Sunday. Didnā€™t feel anything snapping while playing. Next day morning my Achilles were in a horrible position. Two weeks from that, I am able to walk without any discomfort, but then any plantar flexion movement is causing me a very sharp pain. I am fine with dorsiflexion movements though. Been icing it properly, met the physio here, she asked me to start with exercises like seated calf raises, but it hurts a lot while doing any plantar flexion movement. A very sharp pain. Please advise what I should be doing. Thank you
  • @majesticsword
    Excellent Info! šŸ‘šŸ»My pain began going up stairs, going up small paths, and walking a lot! Never had problems with my heels, but I did experience plantar fasciitis before this heel situation started. I also have really bad throbbing pain on the side of my lower leg, itā€™s like a squeeze and a pulsation, exactly where the achilles tendon hurts! My achilles pain gets especially painful when taking my first step in the morning. But, the throbbing on side, of bottom of leg, gets worse when sitting or resting in bed!! Is all this related? It hurts like heck!šŸ„µ I canā€™t walk long distances anymore, and going up steps isnā€™t good either, nor going up a small path. I have also been experiencing a throbbing, sharp pain on the same side of my neck, how messed up all this is!!
  • What to do with the calf and tendon pain in the joint between tendon and calf muscles?...
  • @azor3293
    Question: shoud I avoid swimming(not a sport swimming) if I have Achilles tendonitis. Please, advise. Thank you.
  • @thesuyash
    I am expressing pain for more than a year in both legs. Initially i fell pain in my Achilles and then it goes towards the outer parts of my legs and sometimes to outer side of my thigh also and one time i have experienced back pain associated with this as well. But from the past few weeks i am experiencing pain in the ankle bone, this pain is throughout 24hrs, what can be done , i have consulted multiple doctor but all they suggest is rest or most of them says you don't have anything just go and do whatever you wantšŸ˜¢šŸ˜¢šŸ˜¢šŸ˜¢
  • @HD-xk3km
    Question about a symptom: in addition to the typical tendonitis signs, I often have sharp pain (and internal 'click' sensation) with mild plantar flexion... which mostly worries me because it mainly happens when I'm going down steps, and the sharp stabbing pain around my ankle makes my whole body flinch and puts me off balance. Wondering if this is sometimes part of the picture for Achilles tendonitis/tendonopathy? Thanks for your expert and very helpful videos, Maryke! šŸ†
  • @akashaseekers
    I have both Lipedema and several herniated disks with positive foot drop for about a year. My question is can the Lipedemous fat complicate the tendonopathy? I have pain on the medial side of my left Achilles and it's getting worse. I've had an ultrasound and the tendon is ok, but lots of fluid. And I also have that weird bulbous ball on my Achilles. I do have calcification at the insertion point. I'm waiting for the MRI to be approved. None of the docs that I've seen even knows what Lipedema is. (Not uncommon, tbh) I wear tight knee high compression and I'm not sure if that's making it worse?! Whatever you can offer would be helpful.
  • @elysiumcore
    Used a leg press machine and went too deep - def stretched the achiles tendon - had MRI no tear lots of enflation above insertion - been 1.5 week , can barely walk - taking ibuprofen but Wondering if i should stop as that can delay healing šŸ˜¢
  • @flapinflmingos
    I started experiencing Achilles pain last July. I was brand new and pushed myself too hard. I stopped running completely because of the uncomfortableness even when just walking or at work. Itā€™s now March and Iā€™m still experiencing pain Iā€™m just wondering when it will go away since I went months and months without running. I want to run again but not when I feel like this. This sucks :/
  • I have it since 2018 :( it does not fully go away :( it got better with static tendon holds, tibialis curls and fascia smashing but once I do some bouncing it comes back, cant even imagine running :( the tendons feel sooo weak :(
  • @ginnytilby
    Can Tarsal tunnel syndrome mimic Achilles tendonitis?
  • I have this running injury after ramping up my training and I have no clue what it is. The pain is in both calves and first started behind the knee. Then after massaging and stretching the pain moved lower to my upper inner calves the next day. After working on those the pain then proceeded to move to my Achilles which is why I'm here. It's weird, as it is healing it moves farther down my leg. The pain only occurs on the landing when running and jumping. Pushing off or doing calf raises doesn't affect it at all. Walking is fine but running is a big noooo not even light jogging cuz it can't handle the impact. Any idea what this is? Can't find anything about it on YT. Also I need to be back out there ASAP as I got a race coming up next month
  • @Nadia-km5sv
    I thought I had insertion tendint but with the description of the symptoms I don't think I have that..I went to the doctor this week and he told me to stretch that it would go away with stretching !..I said no, stretching makes me feel worse..in short..with your description tendinitis is not painful at rest. It constantly burns me all around this area (heel, tendon). I can't stand any shoe friction. I don't know who to see to get a real diagnosis. I would like to have your services but I don't speak English..at the moment I use Google translate šŸ˜†.Do you have therapists who speak French?..I live in Canada!!