The largest and strongest tendon in the body, the Achilles tendon connects the calf muscles to the heel bone. It aids in the motions of running, walking, jumping and standing. The Achilles tendon can be vulnerable to injury due to having a limited blood supply and because of its susceptibility to overuse. Tendinitis occurs when the tendon becomes inflamed or irritated. Tendons are thick, fibrous and flexible tissues that attach the muscles of the body to the bones. Achilles tendinitis is commonly associated with the overuse and degeneration of the tendon.
What are the causes and symptoms of Achilles tendinitis?
There are two types of Achilles tendinitis, non-insertional Achilles tendinitis and insertional Achilles tendinitis. Non-insertional Achilles tendinitis occurs when fibers located in the middle portion of the tendon begin to break down due to degeneration and thicken. The other type, insertional Achilles tendonitis, occurs when the portion of the tendon that attaches to the heel bone becomes damaged. Bone spurs often form with this type of Achilles tendinitis, and it is more common in runners due to years of overuse. Often related to repetitive stress to the tendon rather than specific injuries, factors such as a sudden increase in exercise intensity or activity, tight calf muscles and bone spurs can lead to the development of Achilles tendinitis. Symptoms of Achilles tendinitis include swelling, thickening of the tendon, severe pain after exercise or the day after exercise, bone spur formation, stiffness along the tendon in the morning, and pain at the back of heel or along tendon made worse by activity. If the patient experiences a popping sensation in the back of the heel or calf, they may have ruptured or torn the tendon.
How is Achilles tendinitis diagnosed and treated?
In order to properly diagnose Achilles tendinitis, a healthcare provider will conduct a history and physical exam. The provider will look for swelling along the tendon, note if the tendon is thickened, determine if the patient has bone spurs, examine the point on the tendon that is most tender to the touch, measure pain levels at certain points of the tendon and measure range of motion. The physician may also order imaging tests such as X-rays and MRIs in order to confirm the diagnosis and rule out other conditions. Non-surgical treatments for Achilles tendinitis include resting the affected leg, icing the area, cortisone injections, wearing supportive footwear or orthotics and taking non-steroidal anti-inflammatory medication. Surgical treatment for Achilles tendinitis may be recommended if the condition does not improve after extended non-surgical treatment. Physical therapy is often recommended and will focus on helping the patient regain optimal mobility.