Achilles tendinitis is a common condition of the foot which is an inflammation of the Achilles tendon. This connects the calf muscle to the heel bone and is the largest tendon in the body. It is essential for walking, running and jumping. It most commonly happens in runners who suddenly increase their milage, intensity or in weekend warriors, or athletes who play only on the weekends.
Symptoms typically begin with a mild ache in the back of the leg or above the heel. The pain increases in severity without treatment or rest. If the athlete continues activity without treatment he runs a significant risk of rupturing the tendon which requires surgical repair. The area can also feel warm to the touch and be swollen. It will be more stiff and painful in the morning after spending the night in bed and you may have trouble standing on your toes.
A diagnosis is made through history and physical examination. If your doctor thinks there may be bony involvement at the heel, he may order an xray. An MRI may be ordered if the doctor believes there could be a tear in the tendon.
Treatment for tendinitis is to modify your activities to reduce the stress on the tendon. Because this tendon is responsible for walking, you may have to limit the amount of walking you do for a short period of time or your physician may recommend a short period of time on crutches. It can take up to 3 months for the pain to completely go away and you should not return to your previous level of activity until the pain does go away.
Ice the tendon 3 – 4 times a day for 2-3 weeks. Cross training can be included as long as the activity doesn’t cause pain, such as swimming or biking. Once the pain begins to subside you must also stretch the calf muscle and Achilles tendon to ensure that it will return to full function when healed. Do not overstretch the area or you will cause further damage to the tendon.
The injury can become chronic if it’s not treated correctly and quickly. In this case the tendon will thicken with damage and you’ll see swelling only the tendon. You may feel a creaking when you press your fingers into the side of the tendon and move the ankle.
American Orthopedic Foot and Ankle Society: Achilles Tendinitis
Sports injuyr Clinic: Achilles Tendinitis
Runners World: Achilles Tendinitis
MedlinePlus: Achilles Tendinitis
American Academy of Orthopedic Surgeons: Achilles Tendinitis
Mayoclinic: Achilles Tendintis