Achilles Tendonitis

The Achilles tendon is a large cord-like tendon that connects the muscles of the calf to the back of the heel. When you point your toes, the Achilles tendon acts like a rope from the calf muscles to pull the bottom of the heel back. The Achilles tendon allows us to stand on our tiptoes and to push off the ground when running, climbing and jumping.

Tendonitis is an inflammation an irritation of the tissues around a tendon. This irritation results in weakness and pain, particularly when the calf muscles tighten and the Achilles tendon is pulled.

How does Achilles tendonitis occur?
Tendonitis occurs from an overuse of a tendon. This commonly happens from over training or from improper stretching before an athletic activity. This injury is well-known among for athletes, who use the same muscle groups repetitively in sports. Uphill running causes considerable strain on the Achilles tendon, which may lead to tendonitis. Wearing high heels over time can cause the Achilles tendon to shorten and become more prone to tendonitis when low-heeled shoes are worn (which stretches the tendon back to its normal length).

What are the signs and symptoms of Achilles tendonitis?
Achilles tendonitis usually feels like a gradually increasing pain and irritation at the back of the heel and lower calf. This pain worsens with use of the tendon. Swelling of the region may also be present. Small knots or nodules can develop along the tendon, which are accumulations of scar tissue from the irritation and rubbing.

How is Achilles tendonitis diagnosed?
To diagnose Achilles tendonitis, your doctor will discuss the history of the injury with you and examine the back of your leg and heel. X-rays and other imaging tests are not used to diagnose tendonitis, but may be utilized to rule out injury to the nearby bones.

How is Achilles tendonitis treated?
Rest, ice, and conditioning are recommended to help reduce pain and inflammation.

  • Rest - All activities and exercise that require active use of the Achilles tendon should be restricted. Talk with your doctor about a plan for gradually returning to full activity.
  • Ice - Ice packs may be used every hour for 15 minutes at a time to help alleviate pain and reduce swelling.
  • Stretching/strengthening - Your doctor or physical therapist may recommend exercises for the muscles surrounding the Achilles tendon. Other specialized treatments may also be used to decrease inflammation.
  • Casting - In severe cases of Achilles tendonitis, some doctors recommend the use of a cast to immobilize the ankle joint and to reduce the strain on the Achilles.

Talk with your doctor about the best approach for gradually increasing activity during the recovery process.

Recovery from Achilles tendonitis
Recovery time for Achilles tendonitis varies, depending on the severity of your condition. During recovery, it is essential to follow your rehabilitation program properly and limit activities that require heavy use of the Achilles tendon. These steps will help speed your healing process.

How to prevent Achilles tendonitis
It is important to wear comfortable, low-heeled shoes that offer good stability and cushioning. Athletes should maintain proper conditioning and follow training programs that gradually add new exercises. Increasing the length of workouts should also take place slowly over time. With these measures, most cases of Achilles tendonitis can be prevented.