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Achilles Tendonitis

What is it?

Achilles tendonitis is inflammation of the achilles tendon. The achilles tendon is the large tendon located in the back of the leg that connects the calf muscles to the heel bone. When the calf muscles contract, they pull on the achilles tendon, causing the foot to point down and helping you rise on your toes. Hence, the Achilles plays an important role in walking and running. The pain caused by achilles tendonitis can develop gradually without a history of trauma. The inflammation may be localized to the end of the tendon closest to the heel or may spread upward to affect even the muscles of the calf. Swelling often occurs and pain is felt upon contraction of the calf muscles. In severe cases, pain may be felt even at rest. The pain can be a shooting pain, burning, or even an extremely piercing pain.

It is a common problem often experienced by athletes, particularly distance runners.

Individuals who suffer from achilles tendonitis often complain that their first steps out of bed in the morning and initial steps following long periods of sitting are extremely painful. The tendon may take weeks or even months to heal.
 
 
Causes:
  • activities that repeatedly stress the tendon
  • certain foot pathologies
  • over-pronation
  • improper shoe selection
  • inadequate stretching/strengthening
  • short achilles tendon
  • trauma to the tendon

 

How can we help?
 
Early treatment works best and can help prevent more injury. Achilles tendonitis should not be left untreated due to the danger that the tendon can become weak and rupture. Surgery is rarely indicated unless the Achilles tendonitis is particularly severe and chronic, or if the tendon has ruptured completely. Even in mild cases, it can take weeks to months of rest for the tendon to repair itself. It’s important to be patient and not return too soon to sports and activities that stress the tendon.
 
Treatment is based on the severity of the condition: 
  • Stretching exercises
  • Well-cushioned shoes
  • Achilles brace helps to relieve the Achilles tendon without restricting mobility. An anatomically contoured insert (pad) produces a massage effect, thus stimulating the surrounding tissue.
  • Heel cups, cushions or wedges to help raise your heel, which shortens the tendon and takes pressure off.
  • Fabricate custom made orthotics to control over-pronation, support the longitudinal arch and reduce stress on the achilles tendon.
  • Walking boot, or other device to protect the tendon.
  • Provide advice on modified sport activities to reduce stress on the tendon. 
  • May recommend physiotherapy or a rehab program, which can help the lower leg and ankle get strong and flexible again.