Achilles Tendonitis

The Achilles tendon is the strongest and longest tendon in the body. This tough band of tissue runs down the back of the lower leg, connecting the upper calf muscles to the heel bone.

Are you experiencing pain above your heel, or along the length of the tendon, that worsens with activity? An Achilles tendon issue, such as Achilles tendonitis, may be the cause of your discomfort.

Fortunately, with proper podiatric care, foot and heel pain from Achilles tendonitis doesn't have to leave you sitting on the sidelines for long. Learn more about this common condition, including the wide-ranging conservative and advanced treatment options available at Grandville Foot and Ankle.

Types of Achilles Tendonitis

There are two types of Achilles tendonitis:

• Insertional Achilles tendonitis: Which affects the lower part of the tendon where it attaches to the heel bone.
• Non-insertional Achilles tendonitis: Which affects fibers in the midsection of the tendon.

Additionally, this term is often used to describe two kinds of Achilles tendon issues:

• Paratenonitis: An inflammation of the sheath surrounding the tendon, and tendinosis, which is degeneration within the tendon itself. In some cases, people who have problems with their Achilles tendons may suffer from both paratenonitis and tendinosis.

Signs and Symptoms 

In connecting the calf muscles to the heel bone, the Achilles tendon is what enables you to push your heel off the ground to stand on the balls of your feet, as well as walk, run, and jump. As a result, Achilles tendonitis is characterized by pain in the back of the heel and lower leg that is particularly noticeable after exercising or doing other types of physical activity. Other symptoms associated with Achilles tendonitis include:

• Pain in the heel and along the length of the tendon.
• Tenderness or stiffness in the morning that improves with mild activity.
• Ever-present swelling that worsens throughout the day and with activity.
• Weakness in the affected leg.
• Hard knots or lumps in the Achilles tendon.
• Tight calf muscles.
• Limited range of motion when attempting to flex the foot.
• Creaking, cracking, or popping sound when moving the ankle or applying pressure to the Achilles tendon.
• Thickening or enlargement of the tendon.
• Pain caused by shoes applying pressure to the Achilles tendon.
• Skin over the affected area feels overly warm to the touch.
• Severe pain, often the day after exercise or overuse.
• Bone spurs (hard growths that form along the edges of bones).
• Difficulty walking.

The pain caused by Achilles tendonitis can be aching or burning; more severe after prolonged bouts of running or sprinting; and less severe with rest. Sound familiar? Discuss your foot care needs with our skilled podiatrist, Dr. Sarah Stewart.

Causes and Risk Factors 

Achilles tendonitis is typically an overuse injury that happens in response to repetitive or excessive strain on the tendon. Common causes include:

• Suddenly increasing intensity or duration of physical activity
• Failing to adequately stretch and warm-up calf muscles before exercising
• Failing to stretch the Achilles tendon and calf muscles after exercising
• Straining the calf muscles during repetitive physical activities or exercises
• Suffering a traumatic injury or blow to the Achilles tendon
• Exercising in non-supportive, poorly-fitting, or worn-out athletic shoes

This painful condition can affect anyone. However, the following factors may increase your risk of sustaining an Achilles tendon injury.

• Age. The Achilles tendon weakens with age, making older adults particularly susceptible to tendonitis injuries. However, adolescents and teenagers face increased risk due to overuse.
• Sex. While the condition is more common among men, women who wear high heels daily or for prolonged periods are also at risk.
• Structural features. Flatfeet, high arches, tight calf muscles, and other biomechanical issues can make Achilles tendonitis more likely.
• Certain sports. Playing sports that strain the heel, or require quick stops and changes of direction—such as running, tennis, basketball, skiing, and dance—can result in injuries that lead to tendonitis. 
• Other medical problems. Conditions like rheumatoid arthritis, obesity, psoriasis, high blood pressure, bone spurs, and infection are linked to a higher risk of Achilles tendonitis. Taking certain types of antibiotics may also play a role.
• Training practices. Running in cold weather, or on slanted, hard, or uneven surfaces may contribute to the condition.

Diagnosing Achilles Tendonitis 

To diagnose Achilles tendonitis, a podiatrist will conduct a thorough physical examination and ask you about your symptoms. In some cases, the doctor may also order an X-ray or MRI to gauge the severity of the injury before determining the appropriate treatment.

Treatment Options

Prompt treatment of Achilles tendon injuries can help prevent complications like permanent tendon damage or rupture. The sooner you seek treatment for Achilles tendonitis, the more conservative interventions are available.

Conservative treatments include:

• Elevating the foot above heart level (to help reduce swelling)
• Taking a break from weight-bearing exercises or the activity that caused the injury
• Stretching and strengthening exercises
• Padding and taping
• Over-the-counter anti-inflammatory medications such as Advil or Motrin
• Wearing a walking boot or using crutches
• Custom orthotics 
• Icing the affected area (every one to two hours for 15 minutes each time)

If conservative methods fail to yield the desired results, surgery may provide much-needed relief. Such surgeries usually involve removing thickened or scarred parts of the tendon sheath, and repairing ruptures and tears within the tendon itself. A podiatric surgeon may also perform surgery to remove a bone spur that's irritating the Achilles tendon.

Recovering From Achilles Tendonitis 

Even with the best treatment, recovering from Achilles tendonitis takes time and patience. Depending on the severity of the injury and the response to treatment, it can take weeks or months for symptoms to fully resolve. Working with a knowledgeable and experienced podiatrist is the best way to get back on your feet as quickly—and as safely—as possible.

Schedule an Appointment 

At Grandville Foot and Ankle, our team is committed to providing the highest standard of podiatry care. Let us help you get back to doing what you love. Contact us today to schedule an appointment with Dr. Stewart.