Achilles Tendinitis

What is Achilles Tendinitis?

The Achilles tendon, which is sometimes called the heel cord, is known to be the toughest tendon in the human body. It is one of the longer tendons in the body as well, stretching from the heel to approximately the middle of the calf. The Achilles tendon allows for extension of the foot and pointing of the toes. The functions of this tendon make it essential for walking, running, and jumping.

The downside for this prominent tendon is that it is commonly injured. While it has the ability to withstand the demands of walking, running, and jumping, it is prone to tendonitis. Simply put, tendonitis means tendon inflammation. Achilles tendonitis is usually associated with overuse and degeneration and is often characterized by tendon deterioration and tissue disorganization.

Typical symptoms of Achilles tendonitis include pain, swelling of the ankle, decreased motion of the ankle, and decreased strength. The pain that is associated with Achilles tendonitis ranges from mild to severe, and it may come on gradually or suddenly. In addition, patients often report increased ankle stiffness in the morning and increased pain with physical activity, including walking and running.

Causes Of Achilles Tendonitis

Oftentimes, patients describe their Achilles tendonitis as occurring abruptly. However, research has suggested that Achilles tendonitis develops more gradually. Anyone may be affected by Achilles tendonitis, however individuals who participate in high levels of physical activity, particularly activities that involve running or jumping, are more at risk. Additionally, those who only exercise occasionally or who suddenly drastically increase the intensity of their running program are commonly affected by Achilles tendonitis. Achilles tendonitis is usually caused by repeated use and intense strain on the tendon. Additionally, the Achilles tendon weakens with age, making it more susceptible to injury.

Thickening and increased thickness of the tendon can be caused by overload on the tendon. If this overload continues, the tendon becomes stressed which may lead to a disorganization of the tissues in the tendon. Chronic stress and overload on the tendon may eventually lead to degeneration.

Patients that suffer from chronic Achilles tendonitis are more at risk for complications because degeneration and disorganization of the Achilles tendon that reoccurs may lead to small tears in the tendon. These small tears may not completely heal which causes the tendon to become weak, making it more susceptible to more serious injuries, including tendon rupture. Achilles tendon rupture requires immediate medical attention.

Achilles tendonitis is commonly caused by overuse; however, a number of factors have been identified that may increase your risk of suffering an Achilles tendon injury. These risk factors include:

  • Being a middle-aged man
  • Being obese
  • Having tight calf muscles
  • Having diabetes
  • Having high blood pressure

Treatment For Achilles Tendonitis

Many patients who have mild Achilles tendonitis can be treated with conservative treatment methods. These treatment options may include rest, ice, elevation, and physical therapy. Utilizing a variety of treatment options will help to reduce the swelling and pain associated with Achilles tendonitis.

Patients who suffer from chronic tendonitis that persists may require additional treatment options that may include using a cast, boot, or brace that reduces the risk of stress on the tendon while it heals.

Additionally, if the chronic pain is debilitating, steroid injections may be offered. There are two types of steroid injections that can be offered to patients suffering from Achilles tendonitis: intraarticular and periarticular. In the case of an intraarticular injection, the corticosteroid is injected directly into the tendon. For a periarticular injection, the corticosteroid is injected into tissues that surround the tendon. While a corticosteroid injection may provide relief, it is important that patients discuss this treatment approach thoroughly as it has been associated with an increased risk of a ruptured Achilles tendon in the future.

Patients who suffer from Achilles tendonitis are advised to allow time for the tendon to fully recover before returning to regular physical activity such as sports or working out., Full recovery may take weeks to months. It is important to ensure that the tendon is fully healed before resuming normal physical activities, even if the pain, stiffness and muscle weakness are no longer debilitating.

If conservative treatment methods fail, your doctor may suggest surgery to repair the injured tendon. With severe cases of Achilles tendon injury, such as a tendon rupture, surgery is always warranted.