The Achilles tendon is a strong band of tissue that connects the calf muscle to the heel bone. It is used for walking, running and jumping. If the Achilles tendon becomes stressed through overuse or injury, you may develop irritation inflammation, leading to Achilles Tendinitis.
Symptoms of Achilles Tendonitis
The symptoms of Achilles Tendonitis affects the back of your lower leg. You may experience:
- Heel or ankle pain
- Stiffness or swelling of the Achilles tendon
- Discomfort in the back of the lower leg
- Weakness in the lower leg
- Thickening of the tendon, which may appear enlarged
- The formation of bony spurs/lumps where the tendon attaches to the heel
Symptoms are often worse after exercising or when going upstairs or uphill. For some people, the discomfort is particularly intense in the morning and gradually subsides during the day.
Is Achilles Tendonitis the same as Achilles Tendinopathy?
Although the terms Achilles Tendonitis and Achilles Tendinopathy are often used interchangeably, the two conditions are different. Both are caused by overuse or injury and both result in pain and stiffness, however, while tendonitis is inflammation of the tendon, tendinopathy is degeneration of the collagen protein within the tendon. If you have tendinopathy that is left untreated, you may ultimately go on to develop tendonitis.
What Causes Achilles Tendinitis?
Achilles Tendinitis is typically the result of overusing your tendon, which leads to irritation and inflammation. In sport, for example, doing too much and not giving the tendon enough time to repair the injured tissue between workouts can be a primary cause. The condition may develop as the result of:
- Suddenly increasing the intensity or duration of physical exercise.
- Tight calf muscles which increase tension on the Achilles tendon.
- Bone spurs which can develop where the tendon attaches to the heel bone, leading to friction on the Achilles tendon.
- Age and lifestyle. As we age, the Achilles tendon naturally weakens. Middle-aged sportsmen and women may be particularly at risk, particularly if exercise is intermittent and varies in intensity.
Among the people at particular risk of the condition are: athletes particularly middle-aged athletes; runners and dancers; manual labourers and those whose job entails long periods of standing which places the feet and ankles under stress; individuals with anatomical conditions such as overpronation (ankles that move abnormally when you walk) also known as flat arches or flat feet.
How is Achilles Tendinitis diagnosed?
You will be given a physical examination to assess the affected area for tenderness, swelling, range of motion and flexibility. Sometimes you may need a diagnostic imaging test to check the severity of the condition and rule out other possible causes of your symptoms. You may be given an ultrasound, CT scan, MRI scan or X-ray. If you are experiencing symptoms that could indicate Achilles Tendinitis, it is important to get a diagnosis as if left untreated, the condition could lead to an Achilles tendon rupture, which is where the tendon tears or pulls away from the heel bone.
What are the treatments for Achilles Tendinitis?
Treatment will depend on the severity of the condition. In the first instance, using the RICE method can help to relieve symptoms. This entails:
- Rest (Stop doing the activities that led to your symptoms. If you are an athlete, switching to low-impact exercise like swimming can help you to maintain flexibility and fitness without stressing your damaged tendon);
- Ice (Applying ice to the area can help reduce swelling and relieve pain. Never apply ice directly to the skin);
- Compression (Use a compress or surgical tape);
- Elevation (Lying down with your foot raised above the level of your heart helps to reduce swelling).
You may need to use supportive shoes or custom orthotics and a splint at night to help your Achilles tendon stay stretched while you sleep. Taking anti-inflammatory medication can help you to manage pain, and a physiotherapist will be able to recommend exercises to strengthen and stretch the muscles and tendons. Shockwave therapy uses powerful sound waves to promote healing.
If symptoms persist you may need surgery to repair or remove damaged sections of tendon. If more than half the Achilles tendon is damaged, it may not be possible to repair the tendon and you may need a tendon transfer instead. Your orthopaedic surgeon will discuss the most suitable treatment options for you and advise on likely outcomes.
Can Achilles Tendinitis be prevented?
To reduce the risk of developing Achilles Tendinitis, always increase the intensity and duration of exercise slowly, giving your body time to adjust. Make sure you wear the correct footwear when exercising, with shoes that provide good arch support and cushioning. Incorporate calf muscle stretches into your warm-up and cool-down regime. It is a good idea to alternate high-impact workouts like running with low-impact activities like swimming or cycling to reduce stress on the tendon.
If you believe you may have Achilles Tendinitis and would like advice about diagnosis and treatment options, contact us. An early diagnosis can help reduce the risk of developing more serious complications and enable you to return to everyday activities sooner.
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