What is Achilles tendinitis?
Achilles tendinitis occurs when the tendon and calf muscles become strained and inflamed, usually caused by strenuous exercise, jumping, or climbing. The injury to the Achilles can be mild, requiring only rest and over-the-counter anti-inflammatory drugs, or severe, requiring a cast, injections, or surgical repair of the damaged tendon. Chronic Achilles tendinitis can also lead to micro tears in the tissue (tendinosis), which weaken the tendon and put it at risk for severe damage, such as a tear or rupture.
What causes Achilles tendinitis?
- Implementing a new exercise regimen such as running uphill or climbing stairs
- Change in exercise routine, boosting intensity, or increasing duration
- Shoes worn during exercise lack support, either because the soles are worn out or poor shoe design
- Omitting proper warm-up prior to strenuous exercise
- Running on a hard or uneven surface
- Deformation of the foot such as a flat arch, or any anatomic variation that puts unnecessary strain on the Achilles tendon
Pain / swelling
Achilles tendinitis symptoms appear as mild to severe pain (or swelling) near the ankle. The pain may lead to weakness and decreased mobility, which may increase gradually while walking or running.
Stiffness, cracking, weakness
Over time, the pain may worsen, and stiffness in the tendon may be noted in the morning. Physical exam may reveal an audible cracking sound when the Achilles tendon is palpated. The lower leg may also exhibit weakness.
Severe / excruciating pain
This may be symptom of a ruptured or torn Achilles tendon, which requires immediate medical attention. You may also be experiencing impaired mobility, and an inability to point your foot downward, bear weight on the affected side, or walk on the toes.
Rest, stretching exercises, and non-prescription medications to relieve pain and reduce inflammation. Relief of pain and swelling may be achieved with the application of ice for 15 minutes at a time. Sleeping with the affected foot propped up on a pillow may also relieve swelling.
Physical therapy treatments
Depending on your level of pain and inflammation, your doctor may recommend physical therapy, massage, and ultrasound heat therapy to help increase blood flow.
Cast, brace, or walking boot
Persistent Achilles pain may warrant the use of a cast, night brace, or walking boot to be worn for 4-6 weeks stabilizing the tendon so it can heal. After removal of the cast or boot, physical therapy will likely be ordered to increase functionality of the affected limb.
Injections and surgery
To reduce chronic inflammation of the tendon, corticosteroid injections may be prescribed. It’s important to note that this corticosteroid treatment increases the risk of tendon rupture. When all other therapies have failed to or tendon rupture occurs, surgical intervention and repair of the muscles and tendons is the last treatment option.