Achilles Tendonitis

Definition

• Achilles tendonitis is an inflammation and/or degeneration of the Achilles tendon.
• The Achilles tendon connects the calf muscles to the heel bone.
• The Achilles tendon can become irritated for several reasons including:
  • Increasing your speed or running long distances too quickly
  • Suddenly adding strenuous hills or stair climbing to your exercise routine
  • Doing too much too soon after taking time away from exercising
  • A sudden or violent contraction of the calf muscles, such as during an all-out sprint
  • Running too much—overuse
  • Lack of flexibility of the calf muscles

Risk Factors

• Improper or badly worn footwear
• Improper warm-up for your activity
• Inflexibility of the calf muscles
• Improper cool-down
• An improper training program

Symptoms

• Tenderness usually located one to two inches above the point where the Achilles tendon attaches to the heel bone (noticeable in the morning upon rising)
• Stiffness that gradually eases as the tendon is warmed-up
• Pain after activity that gradually worsens
• Radiating or localized pain along the tendon during and/or after running
• Swelling in the area of the Achilles

Diagnosis

• X-rays to see if there is calcium in the tendon
• MRI Scan to view areas of interior damage to the tendon

Treatment

Rest

• Take a break from the activity that caused the tendonitis. Switch to an activity, such as swimming, that doesn’t put stress on the tendon.

Orthoses

• You may be advised to wear a shoe insert that will place your foot in the correct position for walking and running.

Physical Therapy

• Stretching
• Massage
• Ultrasound
• Strengthening exercises

Medications

• Non-steroidal anti-inflammatory drugs (NSAIDs) to ease the pain and decrease inflammation. This is not curative and must be combined with other treatment.

Prevention

• Take the time to warm-up and cool-down properly.
• Wear appropriate footwear for your sport.
• Do not use shoes beyond the recommended duration. This will depend on:
  • o How frequently you exercise
  • o The surface on which you exercise
  • o The conditions in which you exercise
• Gradually add hill work, stairs, speed, and distance to your exercise routine.
• Stretch and strengthen the calf muscles regularly.