The Achilles tendon is one of the most well-known tendons in the body. It’s also the largest tendon, connecting the back of your heel bone to your calf muscles. When this tendon becomes inflamed or degenerates, this is known as Achilles tendinosis. Some people also call this condition Achilles tendonitis, but while similar, these conditions are different. Although common among athletes, this condition can also affect people with tight or stiff calf muscles. It tends to occur in the middle of the tendon or where the tendon and heel bone connect. In this blog we will review Achilles tendinosis symptoms, causes, and what natural treatment of Achilles tendinosis may help reduce pain.
Achilles Tendinosis Symptoms
Achilles tendinosis symptoms are not the same as Achilles tendonitis. Unlike its tendonitis counterpart, Achilles tendinosis is not caused by inflammation. Instead, this condition is a thickening of the Achilles tendon.
Pain is the most common symptom.
The condition is a chronic one that develops over time, and the pain is long-lasting. With Achilles tendinosis, the tendon has become chronically damaged, thick and hard.
What Causes Achilles Tendinosis?
The root cause of Achilles tendinosis is degeneration. People develop this condition for a variety of reasons, but the two most common causes are:
- Overuse from playing sports
As we age, our tendons naturally degenerate, and this can increase the risk of Achilles tendinosis.
However, most people will develop this condition because of physical activity. It’s a common condition that affects runners, but it can affect anyone who plays sports that involve running or jumping. Repetitive minor injuries to the Achilles tendon can eventually lead to this condition, especially if you don’t give the tendon the time it needs to heal.
If you’re a frequent runner or an elite-level runner, you’re at a higher risk of developing Achilles tendinosis. High-intensity training and frequent running put excess strain on the Achilles tendon, which can lead to gradual wear and tear that causes tendinosis.
How is Achilles Tendinosis Diagnosed?
It’s important for your doctor to determine whether you have Achilles tendonitis or Achilles tendinosis. Although similar, these conditions have two different underlying causes, and treatment will depend on which one you have.
An ultrasound will give your doctor a closer look at the tendon to see whether there’s inflammation or degeneration. Inflammation and swelling likely mean that you have tendonitis.
Degeneration is a sure sign of tendinosis.
Treatment of Achilles Tendinosis
Treating Achilles tendinosis is a long-term process. The condition itself doesn’t cause inflammation, so anti-inflammatories may not be effective.
The most common forms of treatment for this condition are:
Your doctor may recommend seeing a physical therapist. Your therapist will work on strengthening and stretching the surrounding muscles to help alleviate the discomfort.
Eccentric contractions, such as heel lifts, tend to be most effective for conditions like Achilles tendinosis. These exercises contract the tendon and muscle while lengthening.
Corticosteroids work by reducing inflammation affecting the tendon. Some doctors recommend this treatment for Achilles tendinosis, but its effectiveness is still up for debate because the condition does not cause inflammation.
Extracorporeal Shock Wave Therapy
Another conventional treatment option for Achilles tendinosis is extracorporeal shock wave therapy or ESWT. With this therapy, shock waves create microtrauma to the tendon to encourage the healing process and alleviate pain.
Although some people have found relief with ESWT, others have not. It’s a controversial therapy that still needs to be researched.
Platelet Rich Plasma
When activated, platelets can produce cytokines that trigger the production of growth factors. Growth factors help with the healing process. Platelet injection into the tissue may help accelerate healing.
While there is evidence that platelet-rich plasma, or PRP, can be helpful for this condition, studies have shown that it’s not much more effective than physical therapy. With that said, if you can’t find relief through any other treatment, it is an option.
Natural Remedies for Achilles Tendinosis
Because tendinosis does not cause inflammation, natural remedies are typically focused on pain relief.
Best known for its immune-boosting effects, vitamin C may also be effective for wound healing, which can help with Achilles tendinosis.
Vitamin C plays a role in all stages of wound healing. Deficiencies can reduce collagen production and lead to the formation of scars.
Supplementing vitamin C can help ensure that your body has enough to complete the healing process.
Curcumin, a compound found in turmeric spice, may help promote healing and boost collagen production. Both of these actions may help those suffering from tendinosis.
In one study, rats whose wounds were treated with topical curcumin healed faster. The study found that the curcumin treatment helped reduce lipid peroxides levels while increasing antioxidant activity.
For those suffering from Achilles tendinosis, curcumin may help encourage healing to the damaged tendon.
CBD (cannabidiol) may be an effective treatment option for people with painful Achilles tendinosis.
CBD creams are a great option because they can be applied directly to the affected area. Although the relief is only temporary, it can help you get through the healing process and complement other treatments.
DMSO or Dimethyl Sulfoxide is quickly and easily absorbed through the skin. It has anti-inflammatory, collagen-softening, and pain-relieving properties which makes it a great pain reliever. DMSO is often used by tendonitis and tendinosis sufferers because of DMSO's ability to amplify the effects of other ingredients. DMSO helps speed up the delivery and amplify the benefits of beneficial ingredients in your pain-relieving creams and gels.
Braces or Tape
Tape or braces may be used to help protect the tendon from further injury. Your doctor or physical therapist may recommend or prescribe a brace. You can also purchase them online.
The right brace, when worn properly, will limit movement in the Achilles tendon to help prevent further damage and degeneration.
Deep Friction Massage
XFF, or deep friction, massage may be helpful for people with Achilles tendinosis. Deep friction massage may trigger the collagen production and fibroblast activity that can aid in the healing process.
For those who are unfamiliar, deep friction massage is a special type of massage developed by Cyriax to help maintain mobility in soft tissues.
The massage must be applied transversely to the tendon. Finding the right spot can be a complicated process and requires a true professional who specializes in XFF massage.
How Long is Recovery?
Any injury to a tendon will take time to heal, and it isn’t a quick process. Even with rest and a solid treatment protocol, you won’t be returning to your normal activities right away.
Tendinosis can take anywhere from three to six months to heal. It’s important to remember that everyone heals at their own pace, so it may take you more or less time to heal.
What is the Outlook for Achilles Tendinosis?
Although recovery can be a long and difficult process, the prognosis for Achilles tendinosis is good. The vast majority (80%) of people will make a full recovery in 3-6 months.
However, if this condition is left untreated, the tendon may eventually rupture. You’ll know if your tendon ruptures because it separates from the tissue and causes severe pain.
A tendon rupture can also cause:
- A snapping sound
- Immediate bruising
- Inability to move, put weight on, or use the affected tendon
Fortunately, most people will get treatment and recover before it reaches this point. If you do suffer from Achilles tendinosis and you’re an active person, it’s important to take preventative steps to prevent re-injury in the future.