Achilles Tendinitis : Causes, Symptoms, Diagnosis, Treatment, Prevention

Definition

Achilles tendinitis is an inflammation and/or degeneration of the Achilles tendon. The Achilles tendon connects the calf muscles to the heel bone.

Causes

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

A risk factor is something that increases your chance of getting a disease or condition.

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

Symptoms

Symptoms may include:

• 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

The doctor will ask about your symptoms and exercise habits, and perform a physical exam.
Tests may include:

• 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 tendinitis. 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

To decrease your chances of getting Achilles tendinitis:
• 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:

1.  How frequently you exercise
2. The surface on which you exercise
3. 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.