Achilles tendinitis refers to inflammation of the heel cord, which is the large tendon that runs down the back of your lower leg. This tendon connects your calf muscles to your heel bone and is designed to provide support when walking, running, climbing stairs, jumping, and standing on your tiptoes.
Although the Achilles tendon can withstand great stress, it is also prone to tendinitis due to overuse and degeneration. There are two types of Achilles tendinitis:
- Noninsertional Achilles tendinitis – fibres in the mid portion of the tendon begins to break down resulting in tiny tears, swelling, and thickening
- Insertional Achilles tendinitis – damaged tendon fibres are inflamed close to their attachment to the heel bone, often associated with the formation of bone spurs
Some common symptoms of Achilles tendinitis include:
- Pain and stiffness along the back of heel or heel cord, especially in the morning
- Pain and swelling that worsens with activity, or end of the day
- Severe pain after exercising
- Swelling of the tendon, that is painful to touch
Achilles tendinitis is typically not associated with injuries but is usually a result of putting repetitive stress on the tendon. Pushing our bodies to do too much, too soon, is often one of the major causes. Other factors include:
- A sudden increase in the amount or intensity of exercise activity
- Tight calf muscles that put extra stress on the tendon
- Bone spur that rubs against the tendon, causing pain
Your orthopaedic specialist will start off with a physical examination to check your foot and ankle for any tenderness, swelling, and thickening of the Achilles tendon, or bone spurs. He or she may also check for tightness of the calf muscles, typical resulting in reduced upward bending of the ankle.
Most of the time your doctor can make a clinical diagnosis. However, you may sometimes be required to undergo an X-ray to look for calcifications within the Achilles tendon or bone spurs, and an MRI scan to check for the extent of degeneration/tears in the tendon.
The mainstay of treatment for Achilles tendinitis remains non-surgical. In the acute phase, resting, applying ice, and taking nonsteroidal anti-inflammatory medications help to reduce the pain and swelling. Physical therapy involving calf stretching exercises are prescribed. Wearing shoe inserts (orthotics) in the form of heel supports or heel lifts can help to take strain off the tendon. Shockwave therapy can also be applied to stimulate healing in the damaged tendon. However, these treatment methods take months to show effect.
If conservative treatments prove to be ineffective after 6 months, your orthopaedic specialist may recommend surgery to lengthen the calf, debride the damaged part of the tendon, remove the bone spur, and either repair the remaining tendon or transfer another tendon in the foot to replace the Achilles tendon (tendon transfer). The surgery to be performed will depend on the severity of your condition.
Every case is different; hence it is best to consult an orthopaedic specialist for an accurate diagnosis so that you can obtain the best treatment option that is most suitable for you. Reach out to us today if you suspect you are suffering from Achilles tendinitis and let us help you enjoy a better quality of life.
Frequently Asked Question (FAQ)
1) Who is at risk of developing Achilles tendinitis?
Individuals who participate in sports or activities that involve frequent jumping, sudden stops and starts, or repetitive movements are at a higher risk of developing Achilles tendinitis. Runners, basketball players, dancers, and athletes who engage in high-impact activities are particularly vulnerable. Additionally, factors such as having tight calf muscles, flat feet, or inadequate footwear that lacks proper support can increase the risk of Achilles tendinitis. Age can also play a role, as the tendon may become less flexible and more prone to injury as people get older.
2) Can Achilles tendinitis lead to more severe injuries if left untreated?
Yes, if left untreated, Achilles tendinitis can lead to more severe injuries, such as an Achilles tendon rupture. Inflammation weakens the tendon, and with continued stress and strain, it can eventually tear or rupture. An Achilles tendon rupture is a much more serious injury and often requires surgical repair. For this reason, it is essential to seek early treatment and give the tendon proper rest to avoid the risk of further damage.
3) Can I use heel lifts or shoe inserts to relieve Achilles tendinitis pain?
Heel lifts or shoe inserts, also known as orthotics, can be beneficial for some individuals with Achilles tendinitis. They can provide extra cushioning and support for the heel, which may help reduce tension on the Achilles tendon and alleviate pain. However, the use of heel lifts or inserts should be done under the guidance of a healthcare professional or a podiatrist. They can assess your specific condition and recommend the appropriate type of orthotics to address your needs.
4) Are there any risk factors for developing Achilles tendinitis?
Yes, several risk factors can contribute to the development of Achilles tendinitis. Participating in sports or activities that involve repetitive jumping or sudden changes in direction can put excessive strain on the Achilles tendon. Having tight calf muscles or limited flexibility in the ankle can also increase the risk. Structural factors, such as having flat feet (overpronation) or high arches (underpronation), can alter the biomechanics of the foot and contribute to tendon overuse. Wearing inappropriate footwear, especially shoes without adequate support, can also be a risk factor for Achilles tendinitis. Understanding these risk factors can help individuals take preventive measures to reduce their likelihood of developing this condition.