The Achilles tendon is the largest tendon in the human body. It is located at the back of the ankle joint and attaches the calf muscles to the heel bone. The Achilles tendon is used to walk, run, jump or push up on the toes. Achilles tendinitis is the inflammation of the tendon and is most often caused by overuse, or is a result of a strain injury.
According to orthopedic foot and ankle surgeon, Dr. Sean Peden, aging and sports activities that involve a lot of calf muscle usage, like basketball and tennis, have a higher incidence of injury to the Achilles tendon. The injury is also associated with a sudden increase of intensity or frequency of an exercise.
“People with Achilles tendinitis usually feel a dull ache or pain during activity and they may feel tenderness above the heel bone, particularly in the morning,” Dr. Peden said. Stiffness that improves as the tendon warms up and mild swelling or a bump are other possible symptoms. However, sudden pain, swelling above the heel, difficulty walking or moving the foot up or down may indicate a rupture of the tendon, Dr. Peden said. “Whenever there’s pain in that tendon area, it’s a good idea to have an orthopedic foot and ankle specialist take a look at it to determine if it is due to tendinitis or a more serious condition such as a partial tendon tear, heel bursitis or a rupture,” he said.
When treated properly, Achilles tendinitis is usually resolved quickly. When left untreated, it may lead to a more serious condition or tear. Some or all of the following may be used to treat the condition depending on its severity:
- Nonsteroidal anti-inflammatory medication
- Orthotics or shoe inserts that help support the muscle and relieve stress on the tendon
- Bracing to restrict motion
- Physical therapy that includes stretching, massage, ultrasound and strengthening exercises
- A home exercise program
Surgical treatments vary depending on the type of Achilles tendinitis a patient has and the severity of it. Some minimally invasive surgical treatments, addressing the calf muscle or heel bone, are new and exciting. If friction between the tendon and its covering sheath causes the sheath to become thick and fibrous and conservative treatments are not effective, surgery may be an option. A surgeon can remove the fibrous tissue and repair any tears. In some cases, where there is severe damage, the Achilles is reconstructed using an adjacent tendon. A temporary cast may be worn during recovery and a rehabilitation program is usually recommended.
Dr. Peden recommends the following tips to prevent Achilles tendinitis:
- Choose a running shoe that provides cushion to the heel.
- Walk and stretch to warm up gradually before exercising.
- Stretch and strengthen the muscles in the calf.
- Increase running distance and speed gradually.
- Avoid unaccustomed strenuous sprinting and hill running.
- Cool down gradually after exercise.