3 slightly different conditions with overlapping symptoms that the Heel Clinic can accurately diagnose and treat differently.
Achilles Tendonitis – involves pain and swelling along the shaft of the tendon, not at the insertion.
Achilles Tendinosis – pain and burning sensations but swelling usually absent.
Achilles Tendinopathy – degeneration of the tendon and a loss of collagen. Usually chronic.
Pain anywhere along the Achilles tendon but can be described as insertional when localised at the back of the heel bone.
Usually pain is worse first thing in the morning as body weight is transmitted through the foot
Pain can ease during activity when the foot warms up
Mild irritation to a chronic state if left untreated
Explosive sports like Football, Netball, Tennis, Hockey etc can aggravate the condition
Can be associated with or without heel spurs
The Achilles tendon attaches the calf muscle complex (gastrocnemius and soleus) to the heel bone (calcaneus). They both create a force that allows the heel to lift off the ground. The calf muscles are very important for movement as they need enough strength to help forward propulsion and enough flexibility to allow for the correct amount of ankle dorsiflexion.
The Achilles tendon transfers this force and flexibility to and from the muscles.
The Achilles tendon constitutes an abundance of collagen fibres and does not have great blood supply. As we age the fibres of the tendon become less force transmitting and less flexible leading to an increased risk of injury.
Achilles injuries occur one of two ways. Through a response that creates inflammation usually due to movement injuries or micro tears that occur without inflammation usually due to degeneration of the tendon.
The Heel Clinic treatment is to assess the functional movement (biomechanics) of the feet in the transition from heel strike to propulsion.
If the root cause during assessment appears be functional, then the clinic uses an insert to support and stabilise the heel, which reduces load on the tendon. The clinic has found that a heel based approach instead of old fashioned arch based support is more effective in treating the ailment.
From this assessment the source and the treatment options can be determined.