Nowadays painful irritation of the Achilles tendon is a widespread complaint, with sufferers including particularly active children and teenagers, as well as adult sportsmen and women.

One would naturally expect achillodynia to be caused by excessive strain placed on the Achilles tendon during sport.

However, this inflammation is usually caused by minimal but constant maldistribution of stress on the muscles that make up the Achilles tendon.

This is caused by constantly wearing shoes with soft soles, which become deformed at the sides when stepping. This means that the calcaneus (heel bone) is no longer vertical to the leg axis, and the two calf muscles are therefore constantly under strain at different lengths.

If the sole is compressed on the outside, this creates a squint plane, which extends the outer calf muscle to the sunken depth, whilst the inner calf muscle is shortened by the same amount.

When the heel is raised and the musculature is tightened, the route taken by the outer muscle is much longer than for the inner. This creates constant rubbing of the Achilles tendon in itself. The outer muscle alone takes care of ensuring that the heel is straight. The necessary additional expenditure of power causes the periosteum to become inflamed where the muscle meets the calcaneus.

Correspondingly, the inner calf muscle is under less strain when the heel is raised. However, the tension in both muscles is the same.

Despite the shorter extension, the inner muscle is kept at the same tension as the outer. This conflictive distribution of stress creates pain in both muscles, but it is stronger on the shortened side.

If the sole of the shoe is compressed on the inside, the pain develops in the same way.

As the maldistribution of stress is very minimal, it can remain pain-free in normal day-to-day life, but will become painfully noticeable during physical activity.

However, if the daily strain is not consistently avoided, permanent healing will not be possible. Bandages or injections of pain relief can relieve the problem but are not expedient.

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