Achilles Tendonitis

What is Achilles tendinitis?

Achilles tendinitis happens when the Achilles tendon that goes down the back of your leg is inflamed and irritated. The Achilles tendon is a strong, fibrous cord, the body’s largest tendon. It links your calf muscles to your heel bone and helps you jump, stand, run, walk, climb stairs, and flex your toes. While the Achilles tendon can endure great stress due to jumping, running, and walking, it is also vulnerable to tendinitis, a condition linked with degeneration and overuse.

Achilles tendon inflammation or tears make it impossible for you to walk or participate in any sport. Every year, nearly 2 million Americans suffer from heel pain. For some people, the pain can be so debilitating that they cannot get up and walk for extended periods without receiving appropriate treatment.

Tendinitis can be classified into two types:

Non-Insertional Tendinitis

Non-insertional tendinitis results from tiny tears in the fibers of your middle tendon and tends to affect young, active adults.

Insertional Tendinitis

Insertional tendinitis affects the portion of the tendon attached to the heel bone. It can affect people of any age, including individuals who are not physically active.

What is the cause of Achilles tendonitis?

A repeated or intense strain that pushes the Achilles tendon beyond its current limit causes tendinitis. As the Achilles tendon ages, its structure weakens, making it more susceptible to injury, especially in people who occasionally play sports or spike their running intensity.

The following factors contribute to tendonitis:

• A bone spur on the heel rubs against a tendon.
• Starting an aggressive workout routine without stretching the calf muscles.
• Increasing your workout intensity or duration drastically without allowing your body to adjust.

What are the symptoms of Achilles tendonitis?

Pain and swelling are the main symptoms of Achilles tendinitis. The pain generally starts as a mild twinge during or after exercise. The severity of pain may increase after sprinting, long-distance running, or stair climbing. There may also be stiffness or tenderness, usually in the morning, that generally goes away with mild physical activity. Likewise, you may find that your calf muscles are tight, and your range of motion is limited when you bend your foot. Tendinitis can also cause the following symptoms:

• Limited range of motion.
• Achilles tendon thickening.
• The inability to stand on your toes.
• Pain when you touch or move your ankle.
• Swelling and pain when running or walking.
• A burning sensation along the heel or tendon.

How is Achilles tendonitis diagnosed?

When diagnosing tendinitis, Dr. Hassan will need to know your symptoms, overall health, and past medical history. As part of the physical exam, he may check for heel spurs or swelling.

In some cases, it may be necessary for Dr. Hassan to order imaging tests to confirm a tendinitis diagnosis. Sometimes Achilles tendon injuries are mistaken for sprained ankles.

How is Achilles tendonitis treated?

Nonsurgical treatment is recommended first for treating Achilles tendonitis. If you’ve already been experiencing symptoms for a few months, it may take a few months for the pain to go away.

Nonsurgical treatment

RICE Method

• Rest: Avoid activities that stress your tendon. Switch to low-impact exercises, like swimming, to reduce the strain on your Achilles tendon.
• Ice: Apply ice to the tendon for up to 20 minutes, as needed.
• Compression: Apply pressure to the tendon using an athletic wrap or surgical tape.
• Elevation:  Lie on your back and elevate your foot above your heart to reduce swelling. 

Other nonsurgical treatments that can help:

• Anti-inflammatory drugs such as ibuprofen.
• Calf stretches.
• Shock-wave therapy.
• Physical therapy.

Achilles tendinitis usually improves after several days of rest and appropriate home therapy. Some pain, however, may last for months. The recovery process could take much longer if you continue applying pressure to the tendon or do not change your exercise routine. The tendon may become weaker as a result of long-term tendinitis.

Can Achilles tendonitis be prevented?

You can lower your risk of tendinitis by doing the following:

• Stretch daily.
• Avoid pain-causing activities.
• Exercise on even, flat surfaces.
• Strengthen your calf muscles.
• Wear shoes with adequate arch and cushioning support.
• Make sure you warm up your muscles before you work out or play sports.
• Adapt to a new exercise routine by gradually increasing your fitness levels.
• Reduce the heel height gradually as you transition from high heels to flats.
• Reduce constant stress on your tendons by mixing high- and low-impact exercises, such as swimming and basketball