I have a chronic Achilles tendon injury that originated with Nordic Walking. Later the injury kept playing up, for example with bodystep and I have stopped doing that for about 4 years now. However, with a longer walk and lunge/exercises I invariably get pain the next day.
My heel bone has ‘grown’ backwards as a result of Nordic Walking. My podiatrist believes that the Achilles tendon is constantly under tension, which causes the recurring complaints (indeed, stretching results in pain the next day). According to him, the only option is surgery, but improvement is not guaranteed. What do you recommend?
marjan
Sepp Mortelmans, podiatrist
I’m sorry that you’re having such a problem with your Achilles tendon. Often, however, the position and function of the foot is also a factor that influences the complaints. The problem can be caused by an isolated incident, by overloading the Achilles tendon (for example, not enough stretching or heat up before exercising) or it is the result of several small moments of stress over the years.
pronate
Usually, Achilles tendonitis is due to an abnormal pronation, where the arch of the foot becomes too flat and the lower leg turns more than normal. As a result, the lower leg muscles (the m.gastrocnemius and m.soleus) stretch more than normal. Just like a rubber band: the further the muscles stretch, the tighter they become. The force on the Achilles tendon and the heel bone (calcaneus) increases, resulting in a painful inflammation.
stretching muscles
Because the arch of the foot flattens over time, especially in avid athletes, a person can be problem-free for years, but still develop Achilles tendonitis years later. You often see this complaint in irregular athletes and in people who have just started exercising. In this last group, the muscles and tendons are not very flexible due to inactivity. People who start exercising excessively can develop tendonitis symptoms because the muscles are not flexible enough to withstand this new load. It is therefore very important that people who are just starting to exercise properly stretch the muscles, start slowly and gradually build up the activities.
Chop
In women who often wear high heels, the Achilles tendon and muscles gradually adapt to the shorter length because the heel is not set all the way to the floor. When this happens, switching to flats or sneakers is a disaster for the Achilles tendon. It then has to stretch more than usual and becomes irritated or inflamed. That is why it is wise not to wear high heels every day, but if this is necessary, stretching the Achilles tendon every morning and evening is highly recommended.
soles
If pain occurs, even after a good warm-up and good training build-up, the cause may lie in the foot malfunctioning or malfunctioning. A podiatrist can investigate this and apply an appropriate therapy. Various therapies are possible, such as sports insoles, shoe advice, temporary relief (sole/or taping) in combination with physiotherapy, walking advice, etc. A combination of therapy is often recommended. You can always make an appointment with a podiatrist without obligation to view the options.
Heel bone growth
What sometimes arises with a long-term Achilles tendon complaint is a haglundse exostosis. This is the growth of the heel bone that you are talking about. This is a bone protrusion, often pointed, that often pushes into the tendon when walking and standing and can therefore cause additional complaints. This is indeed occasionally surgically corrected if necessary. It is best to make an appointment with an orthopedist for further information.
Do you also have a question? Then ask one of our experts. Always go to your doctor with urgent questions, the experts are not the right person for that. They also do not diagnose. You can find the other conditions here.
Sepp Mortelmans is a podiatrist. He is a specialist in the field of ultrasound and foot complaints as a result of rheumatism. You can ask him questions about foot problems in general and his field in particular.
