The Achilles tendon is a strong, fibrous cord located at the back of the ankle, connecting the calf muscles to the heel bone. It plays a significant role in movements like walking, running, and jumping. Experiencing pain in this area, particularly when waking up or taking the first few steps after a period of rest, is a common complaint. This discomfort can range from a mild ache to a sharp, burning sensation above the heel.
Understanding Morning Achilles Pain
Achilles pain often feels worse in the morning due to the tendon’s response to inactivity during sleep. When the body is at rest for several hours, the collagen fibers within the tendon can stiffen and shorten.
Fluid can accumulate between the tendon’s collagen fibers during this time, making nerve endings more sensitive. The sudden stretching and movement upon waking, or after prolonged sitting, can then cause discomfort as the stiffened tendon is re-stretched. The pain typically improves within 10 to 15 minutes as movement helps disperse these fluid deposits.
Common Causes of Morning Achilles Pain
Several conditions and factors can contribute to morning Achilles tendon pain, with Achilles tendinopathy being a common cause. This condition involves inflammation or degeneration of the tendon, often stemming from overuse or repetitive stress. It often results from overuse, such as a sudden increase in activity or intense exercise after being sedentary.
Tight calf muscles also place increased strain on the Achilles tendon, making it more susceptible to injury and morning discomfort. Improper footwear that lacks adequate support or cushioning, such as flat shoes or worn-out sneakers, can put excessive pressure on the tendon. Additionally, activities like walking or running on hilly terrain can increase the load on the Achilles. Weight gain or obesity can further contribute to tendon stress.
Immediate Relief and Self-Care Strategies
For immediate relief and home management of morning Achilles pain, several strategies can help. Gently warming the tendon before putting weight on it is beneficial. Performing ankle pumps and isometric calf squeezes in bed for about 90 seconds can prepare the tendon for movement.
Applying ice to the affected area for up to 20 minutes as needed can help reduce pain and swelling. Resting the injured area and avoiding activities that exacerbate the pain allows the tendon to heal. Wearing supportive footwear, such as shoes with a slight heel or adding a heel lift, can reduce strain on the tendon.
When to Seek Professional Help
Seek professional medical attention if Achilles pain persists despite self-care measures. Worsening pain, severe sudden pain, or an inability to comfortably bear weight on the affected foot are signs requiring medical attention.
Other signs include noticeable swelling around the tendon, a popping sound at the time of injury, or a visible gap in the tendon. Early intervention can prevent minor issues from progressing to more severe injuries, such as a tendon tear or rupture, which may require more extensive treatment.
Professional Diagnosis and Treatment Approaches
A healthcare professional will typically begin diagnosis with a physical examination to assess for tenderness, swelling, and any gaps along the tendon. Imaging techniques like ultrasound or MRI may be used to view the tendon’s condition, detecting swelling, fiber disruption, or tears. X-rays can also be used to check for bone spurs or fractures of the heel.
Treatment often starts with non-surgical options, emphasizing rest and activity modification. Physical therapy is a common approach, involving stretching and strengthening exercises, such as eccentric exercises. Custom orthotics or heel lifts can be prescribed to correct biomechanics and reduce tendon strain. Anti-inflammatory medications, such as ibuprofen, may also be recommended to manage pain and swelling. In rare and severe cases where conservative treatments are insufficient or a tear has occurred, surgical repair may be considered.