The Achilles tendon gets its name from the fabled Greek hero Achilles, who was supposedly killed by an arrow shot into his lower leg near the heel. Now in the age of modern science, we understand that the Achilles tendon plays a critical role in the ambulation and motion of the foot and lower leg as well as providing us with the mobility to walk over uneven ground.
On a functional level, your Achilles tendon attaches your calf muscles to your calcaneus, heel bone. Without it, you wouldn’t be able to jump, walk, run, and even stand confidently on the balls of your feet. Unfortunately, the amount of force it bears over a lifetime or a single exertive day can make the Achilles tendon prone to strains, sprains, complications from localized inflammation, and even tendonitis.
What Are The Symptoms Of Achilles Tenonitis?
Achilles tendonitis can range in severity from minor localized discomfort to chronic pain that hampers your mobility and overall quality of life. Common symptoms of Achilles tendonitis include:
- Pain in the back of your heel when you walk or run
- Localized discomfort and/or noticeable swelling in the back of your heel
- Increasing tightness in the calf muscles
- A reduced range of motion when flexing your foot
- The skin of your heel feel overly warm to the touch
What Are The Causes Of Achilles Tendonitis?
Like a lot of cases of tendonitis, Achilles tendonitis is often associated with overuse of the tendon in the back of the leg, or repeated stress to the ankle, and foot. Though certain things increase your risk of developing it.
- Rheumatoid arthritis
- Localized infections
- Excessive exercise
- Exercising without a proper warmup
- Strained calf muscles
- Sports with quick changes of direction such as tennis
- A recent increase in physical activity
- Poorly fitting shoes
- Frequently wearing high heels
- Bone spurs in the back of the heel bone (calcaneus)
It’s also worth noting that older individuals are more prone to Achilles tendonitis and strains, as connective tissues tend to become stiffer with age.
The Different Types Of Achilles Tendonitis
Most cases of Achilles tendonitis, which can influence your symptoms as well as the possible treatment strategy your physician recommends.
Insertional Achilles Tendonitis
This form tends to affect the lower portion of the Achilles tendon where it attaches to your heel bone. This is also the form that is more common in older individuals.
Non-Insertional Achilles Tendonitis
Tends to affect the fibers in the middle portion of the tendon, and sometimes is dismissed. This form of Achilles tends to affect younger people and athletes, especially those who have recently increased the intensity of their exercise routine.
Can Achilles Tendonitis Be Treated At Home?
Some of the milder forms of Achilles tendonitis can be treated with simple measures like rest, ice, and cessation of activity until symptoms abate.
When Should I See A Doctor For Achilles Tendonitis?
If rest, ice, and cessation of activity don’t start to improve your Achilles tendonitis symptoms within 7 to 10 days you should consider scheduling an appointment with your doctor, as it might be a sign of a minor to moderate tear in the Achilles tendon itself.
How Is Achilles Tendonitis Diagnosed?
Your physician will start with gathering your recent medical history and asking you some key questions. This will help assess the potential underlying causes and severity of your Achilles tendonitis.
At that point, they will likely perform some basic mechanical exams to assess your range of motion in the lower leg and foot. This might include things like asking you to stand on the balls of your feet, lifting your foot, and assessing your overall flexibility. They might also compare the same motions in the unaffected leg.
Your physician might also palpate the muscles and tissues around the Achilles tendon. This involves palpating the area directly to localize and determine where the discomfort or swelling is most severe.
If your physician is concerned that you have more than a minor case of Achilles tendonitis, they might refer you for more advanced diagnostics. This might include things like:
To assess the condition of the leg bones and the possible presence of a stress fracture or bone spurs in the heel bone.
To assess the movement of the tendon, as well as any related inflammation or related damage.
Magnetic Resonance Imaging might be needed to assess if there is a rupture in the Achilles tendon or any other potential signs of tissue degeneration.
How Is Achilles Tendonitis Treated?
Once your physician has assessed the severity and any possible complications associated with your Achilles tendonitis symptoms they will provide you with a customized treatment plan.
For a minor case of Achilles tendonitis, this might include things like prolonged rest and the use of prescription or over-the-counter anti-inflammatory medications. Icing as needed will also help manage inflammation. Your physician will likely request a follow-up appointment in a week or two to assess your progress.
A moderate case of Achilles tendonitis might require more prolonged rest as well as other treatment measures such as a localized steroid injection to address complications caused by inflammation. Platelet-rich plasma injections might also be used to help speed your body’s natural healing processes.
Your physician might also refer you to physical therapy to help improve your flexibility and range of motion. Your therapist will also provide you with basic stretches and exercises you can do at home.
In a more severe case, where the Achilles tendon has been damaged or ruptured, surgical intervention might be needed. Follow-up care will involve physical therapy to rehabilitate the strength of the Achilles tendon as well as restore your natural range of motion in the foot and lower leg.
Can Achilles Tendonitis Be Prevented?
- There are a few things you can do to reduce your risk of developing Achilles tendonitis. This includes things like:
- Stretching before walking or running
- Ease into a new exercise routine
- Combine low-impact and high impact exercises in your exercise routine
- Use cushioning shoes with good arch support or switch to new shoes
- Avoid wearing high heels