What Is Achilles Tendonitis?
The Achilles tendon is a band of tissue that connects the calf muscle to the heel bone. Tendon injuries happen frequently starting with swelling and inflammation, commonly referred to as Achilles Tendonitis.
More Information About Achilles Tendonitis
Types
Tendonitis is the inflammation of a certain area of the body. It is the bodies natural reaction to injury and results in irritation, swelling, and pain. There are two types of of Achilles Tendonitis, Noninsertional and Insertional. The difference between the two is where the swelling occurs in the Achilles Tendon.
Noninsertional Tendonitis
In Noninsertional Tendonitis the middle portion of the tendon begins to breakdown in small bits causing swelling and thickening. Noninsertional Tendonitis is more common among younger and more active people.
Insertional Tendonitis
Insertional Tendonitis occurs in the lower portion of the tendon where the connects with the heel bone. In both Noninsertional and Insertional tendonitis damaged tendonitis may harden, or calcify. Unlike Noninsertional, Insertional injuries will result in bone spurs where extra bone growth.
Insertional Tendonitis can occur in anyone at anytime, not just those that are active. Most commonly it happens as a result of overuse. For example, long distance runners and sprinters.
Causes
Achilles Tendonitis is not the result of a specific injury, but the result of repeated stress on the tendon. Most commonly this is the result of pushing your body to much to often, or to soon. Outside of this, there are several other factors that can lead to Achilles Tendonitis. Things such as increasing the intensity of a workout without giving your body a chance to adjust, working out with tight calf muscles, and bone spurs that causing of the tendon. All can lead to one of the previously mentioned types of Achilles Tendonitis.
Symptoms
Common symptoms of Achilles Tendonitis include:
- Pain and/or stiffness along the tendon in the morning
- Pain and/or stiffness along the tendon and heel that worsens with activity.
- Severe pain the day after excisersing
- Thickening of the tendon
- Bone Spur (Insertional Tendonitis)
- Swelling that is present at all times, but worsens with activity
If you feel and/or hear a pop in the back of your calf or heel you may have ruptured your tendon. See a doctor immediately for diagnosis.
Treatments
Non-Surgical:
Many Non-Surgical Treatments will help reduce pain, but it may take a few months for symptoms to end completely. In some instances the pain will last longer than three months. If you had symptoms for several weeks before seeking treatment it may take six months before treatment begins to work.
Rest: The first step to reducing pain in any area is to stop, or at least reduce the workouts that are causing the pain. For example, if you normally do high impact workouts such as running, try switching to a low impact workout such as swimming. This reduces the stress on your tendon while allowing you to stay active.
Ice: Applying ice on the painful portion of the tendon is a great way to reduce pain and it can be done as needed. Do not apply ice for more than 20 minutes and be sure to stop BEFORE your skin goes numb.
Medication (Non-Steroidal): Certain drugs such as ibuprofen and naproxen can reduce pain and swelling, but they will no reduce thickening of the tendon. Be sure consult your doctor before using medication for more than one month.
Exercise: Stretches and exercises that focus on strengthening the calf muscle are very helpful as the reduce the stress on the achilles tendon.
- Calf Stretch
- “Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 10 seconds and relax. Repeat this exercise 20 times for each foot. A strong pull in the calf should be felt during the stretch.”
- Physical Therapy is been proven to be very beneficial for both Noninsertional and Insertional achilles injuries.
- Eccentric Strengthening Protocol: Eccentric Strengthening is contracting a muscle while the muscle is getting longer. These exercises can be harmful if they are done incorrectly. Initially, these should be done in the presence of a physical therapist, but you once you feel comfortable doing them correctly they can be done at home. Note that these exercises can be uncomfortable and will cause discomfort and small amounts of pain. This pain she be bearable when done correctly. Exercise include:
- Bilateral Heel Drop
- Single Leg Heel Drop
Surgical:
Surgery should only be considered for Achilles Tendonitis only if the pain does not IMPROVE after six months of nonsurgical treatment. The type of surgery depends on the location and level of damage to the tendon.
- Gastrocnemius Recessions: This procedure lengthens the calf muscle. Since tight calf muscles applies pressure on the achilles tendon this procedure can be useful for people who have trouble flexing their feet.
- Debridment and Repair
- Débridement with tendon transfer
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