Achilles tendonitis is a painful and often debilitating condition.
Located in the heel, the Achilles tendon attaches the calf muscle to the heel bone and is responsible for running and walking. The Achilles tendon is the largest, strongest tendon in the human body—which is fortunate, as this tendon also bears the highest loads of any other tendon. In fact, tensile loads can reach up to 10 times the person’s body weight during athletic activities. The incidence of Achilles tendonitis has increased over the past few decades, and currently stands at 18 cases per 100,000 adults.
Achilles Tendonitis Causes & Symptoms
Achilles tendonitis is the acute inflammation of the tendon which runs along the back of the ankle. Factors that can lead to the development of Achilles tendonitis include:
- Athletic activities, such as running and basketball
- Changes in exercise routine, boosting intensity or adding uphill climbing
- Failure to warm up prior to strenuous activity
- Running on hard or uneven surfaces
- Inappropriate footwear
- Certain medications
- Deformation of the foot, such as a flat arch
Those suffering from Achilles tendonitis may first have mild to severe pain with or without swelling near the ankle, which worsens over time. A physical exam could reveal an audible “cracking” sound when the tendon is rotated. Continuing to walk through the pain will worsen the condition.
If the Achilles is ruptured or torn, the patient will experience acute, excruciating pain, and significantly impaired mobility.
Diagnosing Achilles Tendonitis
Muscles, tissues, bones and blood vessels could be evaluated via an X-ray, MRI or ultrasound in order to definitively diagnose Achilles tendonitis. The hallmark “sign” of this injury is extreme soreness when pinching the Achilles.
Achilles Tendonitis Treatment Options
Rest, ice and anti-inflammatory drugs are the typical treatments used for Achilles tendonitis. Depending on the severity of the injury, your doctor may also recommend sleeping with a brace on your foot or elevating the affected foot while sleeping, and could caution you against walking barefoot for any length of time.
Massage therapy can improve blood flow to the area, increase range of motion, and prevent recurrent Achilles injuries. Ultrasound heath therapy and stretching exercises may also be a part of your treatment for Achilles tendonitis. In more severe cases, a cast or walking boot may be required for 4-6 weeks, and corticosteroid injections could be necessary to reduce chronic inflammation of the tendon.
Surgical intervention is generally considered the last treatment option, after all other options have been exhausted.