By Luke Bratton, ATC
Anatomy of Achilles
The Achilles is the large tendon connecting the two major calf muscles to the back of your heel bone. Achilles tendinitis is common and has various reasons on why you may have it. When there is too much stress on the Achilles, the tendon can tighten and is forced to work too hard. When the tendon becomes inflamed, which is called tendinitis, it can produce a covering of scar tissue. This scar tissue is less flexible than the tendon, and with continued stress it can tear or rupture.
Achilles Tendon Injures
Tendinitis to the Achilles Tendon is primarily due to over use in exercises such as walking or running. People can experience Achilles Tendinitis either at the insertional site of the calcaneus or within the mid-substance of the tendon. The years of stress and overuse can also cause the damaged tissue to calcify and create bone spurs. Non-insertional Achilles tendinitis occurs in the mid-substance of the tendon itself. Non-insertional tendinitis typically affects a younger population.
Symptoms of Achilles Tendon Injuries
Achilles tendinitis can be identified if you are experiencing pain and stiffness along the Achilles tendon. This often occurs in the early part of the day. You may also notice an increase in pain along the tendon and the back of the heel after physical exercises. If untreated, the pain will increase during the physical activity and the tendon will also begin to thicken due to inflammation and swelling of the tendon. Achilles tendinitis can lead to further and more severe injury if left untreated. Watch this VIDEO to learn more about the Achilles tendon
Conservative treatment for Achilles tendinitis will typically provide pain relief, however; the process may be slow and can take up to a few months for symptoms to resolve. Initial treatment is resting from physical activity and refraining from high-impact type activities, such as running and jumping. Good alternatives for staying active are biking, swimming, and low-impact cross training.
- Ice is another important aspect of the initial treatment, especially if the tendon remains swollen and tender. Ice up to about 20 minutes per treatment with about an hour in between each session.
- Non-steroidal anti-inflammatory medication (NSAIDs) can also play an important role in controlling the inflammation of the tendon, but should seek guidance from your primary or treating physician.
- Stretching is the last and equally as important aspect in the treatment process. Tight musculature can be one of the causes of Achilles tendinitis, stretching will help reduce some of the stress that is being applied to the Achilles tendon.
If symptoms do not seem to subside you may be a good candidate for physical therapy. Physical therapy can be vital in your recovery from Achilles tendinitis. At physical therapy an individual would be guided through strengthening program to help restore the durability of a weakened tendon. Physical therapy will also provide the use of different modalities such as ultrasound, therapeutic laser, and instrument assisted soft tissue mobilization (or IASTM for short). All of which have been shown to help and reduce tendinitis and other inflammatory issues.
Other Treatment Options
There are also other treatment options available to help assist in the recovery from Achilles tendinitis. You may require the use of orthotics to help correct any mechanical defect that may be leading to cause inflammation. There are also braces and sleeves that may help provide support and stability to relieve stress off of the Achilles tendon while the tendon recovers. To learn more about JOI’s orthotics services read this ARTICLE.
Many athletes suffer from Achilles tendinitis when they over train or fail to stretch properly. There are several factors that contribute to Achilles tendinitis, including tight or fatigued calf muscles, excessive hill running, and inflexible running shoes. Runners who rotate their feet too far inward on impact are the most susceptible to Achilles tendinitis. Initial symptoms of tendinitis can include dull or sharp pain anywhere along the back of the tendon, but usually close to your heel. Also, limited flexibility, redness or heat over the painful area, a cracking sound when you move your ankle, or a small lump located on your tendon can be symptoms of tendinitis.
Modify Your Running
If you suffer from any of these problems, you should stop running or training, take aspirin or ibuprofen, and then ice the injured area from 15 to 20 minutes several times a day until the pain subsides. Once the lump is gone, stretch your calf muscles and don’t start running until you can do toe raises without pain. Returning to physical activity should be a gradual process and not rushed. In case the injury doesn’t respond to self-treatment within two weeks, you many want to see a physical therapist or doctor.
For an appointment with a Orthopaedic Foot and Ankle MD, please call JOI-2000 or follow the link below.
- To schedule a new patient or follow up patient appointment with your MD, please call (904)JOI-2000 or read more here about our orthopedic telemedicine providers.
- To schedule an appointment for physical or occupational therapy, call 904-858-7045 or call any of the 12 area JOI Rehab Centers.