Achilles Tendinitis

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.

Aging and sports activities that involve a lot of calf muscle use, like basketball and tennis, have increases the risk of injury to the Achilles tendon. The injury is also associated with a sudden increase of intensity or frequency of an exercise.

SYMPTOMS

• A dull ache or pain during activity
• Tenderness, particularly in the morning, above the heel bone
• Stiffness that improves as the tendon warms up
• Mild swelling or a bump

If you feel a sudden pain or swelling above the heel and difficulty walking or moving your foot up and down, you may have ruptured the tendon.

TREATMENT 

It is important to consult with an orthopedic foot and ankle specialist whenever you feel pain in the Achilles area to determine if the pain is due to tendinitis or more serious conditions such as a partial tendon tear, heel bursitis or a rupture.

When you treat it properly, Achilles tendinitis usually resolves quickly. When left untreated, it may lead to a more serious condition or tear.

Your doctor will recommend some or all of the following to treat the condition depending on the severity of the injury:

• Rest
• Nonsteroidal anti-inflammatory medication
• Orthotics or shoe inserts that help support the muscle and relieve stress on the tendon
• Bandaging to restrict motion
• Physical therapy that includes stretching, massage, ultrasound and strengthening exercises

If friction between the tendon and its covering sheath causes the sheath to become thick and fibrous, conservative treatments may not be  effective. In this case, your physician may recommend surgery as an option. Your surgeon can remove the fibrous tissue and repair any tears. You usually wear a temporary cast during recovery and your physician will recommend a rehabilitation program.

PREVENTION

• 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.

Orthopedic Foot and Ankle Surgeon, Dr. Michael Clain, discusses Achilles Tendonitis in the video below.