Do You Have Achilles Tendinitis?

Do you have pain at the back of your foot, just above the heel?  It could be Achilles Tendinitis.  Achilles Tendon

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. This tendon is used to walk, run, jump and 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.

SOME CAUSES

According to orthopedic foot and ankle surgeon, Dr. Mark Yakavonis, 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. Achilles tendinitis 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. Yakavonis 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. “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.

TREATMENT

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:

  • Rest

  • 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 TREATMENT

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.

PREVENTION

Dr. Yakavonis 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.

What’s Causing Your Heel Pain?

The foot has more than 30 different joints. If you consider the tons of stress your feet endure from walking and standing day in and day out, it’s no wonder that heel pain is the most common problem affecting the foot and ankle.

“Feet are anatomically designed to handle the pressure … to a point,” said orthopedic foot and ankle specialist, Mark Yakavonis, MD, “Repeated pounding on a hard surface while running, participating in another sport, or wearing ill-fitting shoes that inflame the foot’s tissues can cause pain on the bottom of your heel or behind it. Arthritis, wear and tear, or a build-up of uric acid in the small bones of the feet, known as gout, can also cause heel pain.

In most cases, heel pain can be relieved without surgery. Rest, stretching exercises, and possibly anti-inflammatory medication can usually do the trick. If left untreated, Dr. Yakavonis warned, a sore heel will only worsen and can develop into chronic and more problematic conditions.

For that reason, it’s important to consult with a an orthopedic foot and ankle specialist to determine the underlying cause of pain in your heel if it lasts more than a few days. A medical consultation is particularly imperative if the pain  intensifies when you put weight on the foot, if there are signs of infection or injury, such as swelling, discoloration or fever, or if your heel is warm to the touch.Foot picture

SOME COMMON CAUSES 

According to Dr. Yakavonis, pain under your heel can occur if you’ve bruised the heel pad by stepping on a hard object such as a rock, or from repetitive pounding on hard surfaces during sports. This pain usually goes away over time with rest.

If the pain beneath your heel is mild at first but then flares up when you take your first steps in the morning, you may have plantar fasciitis, This condition  is caused from inflammation of the tissue band (fascia) that connects the heel bone to the base of the toes. Plantar fasciitis is the most common condition causing heel pain. If plantar fasciitis is left untreated, a painful heel spur (calcium deposit) can develop where the fascia attaches to the heel bone.

PAchilles Tendonain from behind the heel could indicate inflammation of the bursae and the Achilles tendon at the point where the tendon goes into the heel bone. Achilles tendinitis and associated pain from retrocalaneal bursitis can build slowly over time, causing the skin to thicken, become red and/or swell. In some cases, a bump that feels warm to the touch can develop at the back of the heel. If pain increases with the start of an activity after a period of rest or if it is too painful to wear shoes, your physician may order an X-ray to determine if a bone spur has developed.

Injuries to the nerves in the foot can also produce heel pain. Neuropathy, or nerve damage, and Tarsal Tunnel Syndrome, in which the large nerve in the back of the foot becomes pinched and inflamed, are the two most common nerve-related conditions.

If you experience pain that makes it difficult to walk or enjoy your everyday activities, schedule an appointment at ONS with one of our foot and ankle orthopedic specialists, Michael Clain, MD or Mark Yakavonis, MD, by calling 203-863-1145 or request an appointment here.

07/10/2019