Achilles Tendonitis

Achilles tendonitis is a common condition in which the large tendon in the back of the ankle is irritated and becomes inflamed. This can be caused by one single event, which is an “Acute” injury, or over time, which is a “Chronic.” It is a common injury that occurs with our “Weekend Warriors.” This inflammation can be caused by an over load of the Achilles during activities like running or jumping. Usually a specific event causes a strain or tear of the Achilles tendon. Due to small to medium tears in the tendon at or close to the insertion into the calcaneous or heel bone. These tears cause inflammation that lead to increased swelling and then pain.

Common causes of Achilles Tendonitis include lack of flexibility, failing foot wear, sudden increase in exercise schedule, flat feet, and improper stretching. The area of the Achilles that is most commonly affected is close to the heel where the tendon attaches to the back of the foot. This part of the Achilles is at risk of injury because there is less blood in this part of the tendon. This area is called the “Water Shed Area” because as we age it has less blood flow to the area and more tendon sheath that contains mostly water. Achilles Tendonitis can present itself higher on the upper legs as swelling, pain, or a bump. The area may increase in size and tenderness with activities like walking, running, or jumping. Wearing a backless shoe will also aggravate the area.

When the Achilles tendon is completely torn this is called a ruptured. This complete tear is due to an overload to that area to the point that it tears. It will be very difficult to walk or move the foot or ankle with this injury.

Treatment Options

Treatments for Achilles tendons consist of rest, ice, compression, and elevation or“R.I.C.E.” Anti-inflammatories are also recommended for treatment of tendonitis. In more serious situations, immobilization of the foot and ankle may be necessary. Even though x-rays are usually negative, they are often ordered to rule out other possible conditions. An MRI is ordered to evaluate the significance of the tissue injury. Additional treatments for severe cases may include medications, injections, braces, strapping, inserts, custom orthotics, or surgery.