ACHILLES TENDINITIS

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The Achilles tendon is the most powerful tendon in the body. It connects the back of your calf muscle to your heel bone and enables movement in the ankle.

Achilles tendinitis is a common overuse injury of the achilles tendon and is most common in runners who have suddenly increased the intensity or duration of their runs. We also commonly see this in middle-aged adults who continue to play sports regularly.

Description

Achilles tendinitis, also spelled tendonitis, is simply acute inflammation of the achilles tendon. We know that inflammation is our body’s natural response to most injuries. This often causes pain, swelling, and overall irritation.
When researching achilles tendon injuries, you may come across the term, “Tendinopathy”. This occurs when the achilles tendon starts to develop tiny tears as a result of chronic damage.

In the medical field, we use the terms, tendinitis, tendinitis, and Tendinopathy to describe conditions that essentially have the same root issue.

However, achilles tendinitis is different than an achilles tendon rupture. An achilles tendon rupture occurs when the achilles tendon becomes separated completely off of the heel bone or is torn in half. While achilles tendinitis is normally a result of overuse, over time, an achilles rupture is caused by a sudden injury.

Achilles Tendon Injuries

Achilles tendinitis can be divided into two categories, depending on which parts of the achilles tendon sustain injuries:

Noninsertional Achilles Tendinitis

When the fibers in the mid section of the achilles tendon break down, this causes non insertional achilles tendinitis. We tend to see this type of achilles tendon injury in younger adults.

Insertional Achilles Tendinitis

Insertional achilles tendinitis affects the muscle directly adjacent to the heel bone, specifically where the achilles tendon meets the back of the heel.

This type of tendinitis can affect those who are physically active, as well as those who are not.

Achilles Tendon Rupture

As mentioned, achilles tendon ruptures are different than tendonitis, as the tendon moves completely off of the heel bone or is completely torn in half.

A ruptured tendon will usually require achilles tendon surgery.

What Are The Symptoms of Achilles Tendinitis?

Pain that occurs due to achilles tendinitis will typically begin as an ache in the back of the leg or above the heel. This pain will occur after running or another sports activity.

More severe pain may occur after prolonged running, stair-climbing, or sprinting.

Tenderness and stiffness are also possible, especially in the morning. This feeling will usually improve with mild activity.

You should see a doctor when you start experiencing persistent pain around the Achilles tendon. You should seek immediate medical attention if the pain or disability is particularly severe.

If the achilles tendon ruptures, you should know it. The pain will come instantly. You may also hear a popping sound.

Besides pain or swelling, those affected may also experience the following symptoms of achilles tendonitis:

tight calf muscles
limited range of motion, such as the inability to flex your foot
pain specifically behind the heel when it’s touched
bone spurs
swelling that worsens with activity
a thick band that develops on the back of your heel bone
stiffness when you first wake up in the morning
difficulty standing on the balls of your feet
a warm sensation around the area

Why Do I Have Achilles Tendinitis?

With most achilles tendon injuries, the culprit is typically overuse. So, when we diagnose achilles tendinitis, achilles tendinosis, achilles tendinopathy, etc. we understand that there may not be a specific moment that the patient realized the injury occurred. Instead, it occurs because the patient overused the tendon over time.

Achilles tendinosis occurs more often in those who engage in actions where they must speed up or slow down quickly or must pivot in place frequently.

Some are more susceptible to achilles tendon disorders, predispositions include but aren’t limited to:

Sex – Achilles tendinitis is most common in men
Age – the older you are, the more common Achilles tendinitis becomes
Medications – certain types of antibiotics are correlated with higher rates of Achilles tendinitis
Medical Conditions – those who have psoriasis or high blood pressure are at a higher risk of developing Achilles tendonitis
Training Choices – running in worn-out shoes increases the risk of Achilles tendinitis. Tendon pain will occur more frequently in cold weather and running in hilly terrain can predispose you to Achilles injury.
Physical Problems – If you have flat feet more strain is placed on the Achilles tendon. Obesity and overly-tight or weak calf muscles are also contributing factors.

How Does a Doctor Diagnose Achilles Tendinitis?

During your physical exam, your doctor will press on the affected area to determine the source of your pain. The physical exam will also help your Pain Relief Center physician determine the flexibility and range of motion in your foot and ankle. Your doctor may also order one or more imaging tests to assess your condition.

Some possible imaging tests they may order are:

MRI Scan – this uses radio waves and has a strong magnet. An MRI can produce very detailed images of the Achilles tendon.
Ultrasound – an ultrasound uses sound waves to visualize your soft tissues. Therefore, an ultrasound can show the doctors at Pain Relief Center real-time images of your Achilles tendon. Color-Doppler ultrasound can even help evaluate the blood flow around your Achilles tendon.
X-ray – this can’t visualize soft tissues, like tendons, but they are helpful in ruling out other conditions.

Treating Achilles Tendinitis

Tendinitis responds well to self-care methods. If your early morning foot pain is a result of Achilles tendinitis, the pain will be localized to the tendon area, on the back of your ankle above the heel. Stretching this area several times throughout the day can be helpful in alleviating symptoms.

Over-the-counter anti inflammatory pain medications such as ibuprofen or naproxen (Aleve) will help reduce inflammation and relieve pain. Avoiding exercise for a few days or switching to an activity like swimming that doesn’t strain the Achilles tendon can help ease the pain. In cases where there’s damaged tendon tissue and we really need to ensure that the tendon doesn’t move, we may provide a walking boot.

We may offer steroid injections, such as cortisone injections, or shockwave therapy to promote healing of this overuse injury.

Achilles Tendinitis Surgery

If physical therapy isn’t addressing your achilles tendon disorders or if your achilles tendon is torn, Dr. Rodriguez may recommend to respected foot and ankle surgeons in the area. The Dallas/Plano area is home to many brilliant orthopaedic surgeons who may be able to provide help with your injury doesn’t respond to nonsurgical treatments.

How Do I Prevent Achilles Tendinitis?

It isn’t always possible to prevent Achilles tendinitis. But you can take measures to reduce your risk. Some of these measures are:

Increase your activity level gradually. Start your exercise regimen slowly and gradually increase the duration and intensity of your training. Our physical therapist can recommend an exercise routine with appropriate strengthening exercises.
Take it easy. Avoid activities that place extra stress on your tendons. If you do participate in strenuous activity, warm up first by exercising at a slower pace.
Choose your shoes carefully. The shoes you wear while exercising should provide adequate cushioning for your heel and firm arch support. This helps reduce the tension in the Achilles tendon. Replace your worn-out shoes and wear shoes that support your lifestyle.
Stretching exercises. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise, and after exercise.
Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendon to better handle stress.
Cross-train. Alternate high impact activities with low-impact activities. For instance, if you are a frequent runner, supplement some of your runs with swimming.

Treatment for Achilles Tendon Injuries in Plano, Texas

Our pain management specialists have several treatment options available for those suffering from an achilles tendon injury or bone spur. Request an appointment by filling out our online form or calling our office!

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