Health Center :: Achilles Tendonitis

The Achilles tendon, located on the leg, attaches the calf muscle to the heel bone. Achilles tendonitis is a repetitive strain (overuse) injury involving lower leg muscles and tendons at the point where they attach to the bone, resulting in pain at the back of the ankle. Chronic overuse can lead to small tears within the tendon causing long-term weakening, making the tendon susceptible to rupture, which could result in a need for surgery.

How do you know if you have Achilles tendonitis?

Achilles tendonitis causes pain and often swelling of the tendon that attaches the calf muscle to the heel bone. If you are suffering from Achilles tendonitis, your main complaint is likely to be pain and stiffness over the back of the heel.  The tendon is tender and may be swollen, stretching of the tendon can be extremely painful and the range of motion of your ankle may be limited.

Physical activity, especially strenuous activity like running or tennis can increase the pain and inflammation. Achilles tendonitis may be caused by a single incident of overstressing the tendon, or it may result from a series of stresses that produce small tears over time (overuse).

Typically, you are able to self-diagnose Achilles tendonitis. In other cases, x-rays may be required to reveal the injury. In all cases, your doctor is best able to diagnose your condition.

How does Achilles tendonitis occur?
Lack of flexibility and overpronation are two of the most common causes of Achilles tendonitis.  Other risk factors and causes include:

Poor conditioning:  Exercising beyond your conditioning is one of the most common and direct routes to injury. “Jumping right in” puts you at risk for developing Achilles tendonitis.  Whether you are a somewhat “out of shape” weekend warrior participating in activities that involve sudden stops and starts and repetitive jumping (e.g., basketball, tennis, dancing) or a well-intentioned beginner who is starting a new fitness program it’s likely that your muscles and tendons have little flexibility because of inactivity.  Stretching properly, starting slowly, and increasing gradually will be critical if you want to avoid Achilles tendonitis.

Overuse: Achilles tendonitis may occur as a result of overuse or training too much as well.

Stressful surfaces:  Participating in repetitive motion activities, such as running, playing basket ball or tennis that are done on hard surfaces (especially pavement, cement or hills) can increase your chances for developing Achilles tendonitis.

High-heels:  Women who wear high-heeled shoes often and switch to sneakers for exercise also can develop Achilles tendonitis. The Achilles tendon and lower leg muscles gradually adapt to a shortened position because the shoes prevent the heel from stretching all the way to the ground.  When this occurs, wearing sneakers or flat shoes forces the Achilles tendon to stretch further than it is accustomed to, causing inflammation. If high heels are worn everyday, stretching should be done every morning and night to keep the Achilles tendon lengthened.

How can Achilles tendonitis be prevented or treated?
As with all injuries, prevention is your best defense especially with injuries that are as painful and inconvenient as Achilles tendonitis. 
Prevention options include:

Stretching: To help maintain flexibility in the ankle joint, begin each day with a series of stretches and be certain to stretch prior to, and after, any exercise or excessive physical activity.

Appropriate exercise routines: Be smart about your exercise choices.  Avoid activities held under less than ideal conditions, warm up before any exercise, including a friendly pick-up game and don’t overdue it.

Proper footwear: Low-heeled shoes with good arch support and shock absorption are best for the health of your foot.  Look into heel wedges and other shoe inserts to make sure that your everyday foot mechanics are operating under ideal conditions. 

Treatment options for Achilles tendonitis are focused on relieving suffering and promoting healing.

Most doctors recommend rest, ice, compression and elevation to reduce inflammation, relieve pain, minimize swelling and promote healing.  Other treatments include:

Orthotics and Heel Support: Bio-mechanically engineered inserts and heel cups which can be placed in your shoes to correct mis-alignments, or to bolster the support of your foot are available without a prescription. The temporary heel padding that these provide reduces the length that the Achilles tendon stretches each time you step, making it more comfortable to go about your daily routine.

Nonsteroidal anti-inflammatory medications: These medications are available over-the-counter or as a prescription for pain relief, and to reduce swelling. Be sure to talk to your doctor before starting these medications.

Physical Therapy/Rehab: Post injury physical therapy may be prescribed by your doctor based on the severity of your injury.  Whether done at home or with a Physical Therapist, these exercises are likely to include calf and hamstring stretching.

Where tendon rupture is concerned, operation is likely necessary.  If you think that you may have ruptured or torn your tendon you should have it looked at by a doctor immediately.

Suffers of Achilles Tendonitis have found these products helpful
in controlling pain, providing support and strengthening the Achilles tendon: