The largest tendon in the body, the Achilles tendon is located at the back of the leg just above the heel. This fibrous band of connective tissue connects the calf muscles to the heel bone, and it is used in walking, running, jumping and pushing up on your toes. An overuse injury, Achilles tendinitis is characterized by pain and swelling along the tendon and in the heel. Symptoms may be more pronounced in the morning, and stiffness upon awakening may also occur.
To diagnose Achilles tendinitis, your physician will look at the affected area and gently press on it to determine if tenderness is present. Your doctor will also check for swelling, thickenings in the tendon, bony spurs on the heel, and limited range of motion in the ankle. Conventional X-rays can help diagnose bone problems in the area of the Achilles tendon. If the physician suspects that the tendon is torn or plans to perform surgery, an MRI will offer a more detailed view of the soft tissues that need repair.
Causes of Achilles Tendinitis
Achilles tendinitis is caused by repetitive stress placed on the tendon. This type of strain can occur when you push yourself too hard at the beginning of a new fitness program or when you suddenly increase the intensity of an established exercise routine. Other risk factors for an inflamed Achilles tendon include having flat feet or tight calf muscles, both of which place excess stress on the tendon. Also, bone spurs on the heel can cause pain by rubbing against the Achilles tendon. Not wearing supportive shoes, running on hard surfaces or hilly terrain and having diabetes or hypertension also place you at a higher risk of developing the condition.
Treatments for Achilles Tendinitis
The majority of Achilles tendinitis cases respond to conservative treatments. Resting the tendon is the first course of action, so you should stop performing the activities that caused the condition in the first place. For instance, if you regularly run or perform other high-impact exercises, you should switch to biking or swimming to alleviate stress on the tendon. Placing ice on the affected area several times a day for up to 20 minutes at a time can also offer relief. Your doctor may additionally recommend taking non-steroidal anti-inflammatory medications for a short time to help relieve the pain and swelling.
Your physician may advise you to see a physical therapist, who can teach you muscle-building and stretching exercises to help heal the Achilles tendon and strengthen its supporting structures. Your physical therapist may also offer footwear advice, which can include choosing shoes that have more cushion in the heel area, using a heel lift in your shoes or wearing a custom orthotic boot to stabilize the heel and Achilles tendon while they heal.
Reversing the damage of Achilles tendinitis using noninvasive methods can take several months. If you do not find relief within six months, your doctor may recommend surgery, which can involve lengthening tight calf muscles, removing bone spurs from the heel, removing damaged tendon tissue or performing a tendon transfer to strengthen the Achilles tendon.
Achilles tendinitis is a result of repetitive strain on the tendon that connects the heel and the calf muscles. Pushing yourself too hard while exercising and routinely performing high-impact exercises are just a couple of reasons that the Achilles tendon may experience pain and inflammation. Noninvasive treatments such as rest, switching to low-impact exercises, taking over-the-counter pain relievers and undergoing physical therapy can usually help reverse the condition so that you can avoid a surgical procedure.