Achilles Tendonitis is a term that commonly refers to an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may occur in other activities that requires the same repetitive action. Most experts now use the term Achilles tendinopathy to include both inflammation and micro-tears. But many doctors may still use the term tendonitis out of habit.
Tendinitis typically develops after abrupt changes in activity or training level, use of poorly fit or worn footwear, or training on uneven or dense running surfaces. Overuse prior to sufficient training is generally the cause. This is due to forces 8-10 times the body weight acting on the tendon during physical activity. Achilles injuries range from inflammation to a breakdown in the tendon. Pain is generally felt low on the back of the heel due to the low vascularity and susceptibility for inflammation. Pain higher on the Achilles is generally more muscular pain and less tendonitis. If swollen spots or knots are found along the tendon, or if the tendon feels jagged, cease activity and seek professional medical care.
Common symptoms of Achilles tendinitis include, pain and stiffness along the Achilles tendon in the morning, pain along the tendon or back of the heel that worsens with activity, Severe pain the day after exercising, thickening of the tendon, bone spur (insertional tendinitis) swelling that is present all the time and gets worse throughout the day with activity, If you have experienced a sudden “pop” in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.
In diagnosing Achilles tendonitis or tendonosis, the surgeon will examine the patient?s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities.
The best treatment for Achilles tendonitis is preventative, stretching and warming up properly before starting an activity. Proper rest, accompanied by stretching and icing to reduce swelling, can help to heal an overworked Achilles tendon. Placing an adequate heel lift in both shoes will allow the heel to have contact with the ground without placing stress on the Achilles tendon. Wear a tie shoe that is stiff soled and has a wide base, then add an over-the-counter or custom foot orthosis inside the shoe to prevent the twisting motion of the Achilles tendon due to over pronation. In the event that the tendon is unable to heal due to your life style or activity, you may have to be put in a walking cast for a short period to give it a chance to heal. You need to have the doctor, physical therapist, or come in to our facility to check for a leg length difference due to the walking cast being higher. This is to prevent any discomfort to the hips. After the tendon has healed and before the foot is taken out of the walking cast, range of motion at the ankle must be tested and if the foot is not allowed to properly bend upwards 15 degrees then the tightness in the calf will cause the foot to over pronate and reinjure. A stretching program will be needed to loosen up the calf muscle before much weight bearing is done without the cast. The stretching program can be found at the menu for feet hurt. If necessary a heel lift can be put in both shoes to help take the stress off the tendon. Should the tightness of the calves be the primary cause for the Achilles tendon damage and stretching has not loosen the Achilles tendon sufficiently, then discussion with your doctor for a calf release may have to be considered.
As with any surgery there are risks to every procedure depending on a lot of factors, including your age, the severity of your injury and your level of health going into the procedure. It is always best to discuss all possible risks and complications with your doctor, orthopaedic specialist and/or surgeon before the procedure. It’s important to be aware of the risks you may face with any procedure intended to fix or relieve pain from your Achilles tendon injury.
A 2014 study looked at the effect of using foot orthotics on the Achilles tendon. The researchers found that running with foot orthotics resulted in a significant decrease in Achilles tendon load compared to running without orthotics. This study indicates that foot orthoses may act to reduce the incidence of chronic Achilles tendon pathologies in runners by reducing stress on the Achilles tendon1. Orthotics seem to reduce load on the Achilles tendon by reducing excessive pronation,