Overview Of Achilles Tendon Problems
Achilles tendinitis occurs when the Achilles tendon (the tendon that connects the back of the leg to the heel) becomes painful and swollen, usually near the bottom of the foot. The tendon normally allows the body to push the feet downward, and is used when walking, running, and jumping. Achilles tendon problems have the potential to greatly limit mobility.
Commonly Associated With
Tendinitis of the heel, and heel pain associated with the Achilles tendon
Causes Of Achilles Tendon Problems
There are two large muscles located in the calf, and they generate the power the body needs to push off with the foot or extend up onto the toes. These muscles are connected to the muscles of the heel via the Achilles tendon. Pain in the heel is most often due to overuse of that particular foot, although it can be caused by injury in some cases.
Tendinitis associated with overuse is most often seen in young people. It can occur in runners, walkers, or other types of athletes.
Achilles tendinitis is more likely to occur if:
- Calf muscles are very tight and proper stretching does not take place before the exercise begins.
- The person runs too often.
- The foot suddenly turns out or in.
- There are sudden increases in the amount or intensity of the person’s activities.
- They are exercising often on hard surfaces, such as concrete.
- Not wearing shoes that give the feet proper support.
- Jumping a lot, such as when the person plays basketball.
Tendinitis due to arthritis is more common in middle-aged and older adults. Another possible reason could be that a bone spur or growth has formed in the back of the heel bone, which can irritate the Achilles tendon and cause swelling and pain. Flat feet can also put more tension on the tendon.
Symptoms Of Achilles Tendon Problems
Symptoms typically involve pain along the length of the Achilles tendon and in the heel when running or walking. The area can feel stiff or painful, especially in the mornings.
The area of the tendon may be painful to move or touch, and can be warm and swollen. The person may have trouble standing on their toes or finding shoes that fit comfortably.
Exams and Tests
A health care provider will perform a physical exam, and they will check for tenderness along the tendon and if there is any pain in the area when the patient stands on their toes.
X-rays can be used to help diagnose potential bone problems of the heel.
An MRI of the foot can be done if the person is considering surgery, or if there is a chance that they have a tear in their Achilles tendon.
Treatment Of Achilles Tendon Problems
Most treatments for Achilles tendinitis DO NOT require surgery. The pain typically goes away in around 2-3 months with proper treatment.
A common treatment is to apply ice to the Achilles tendon area for 15-20 minutes, 2-3 times per day. The ice should be removed if the area feels numb to the person.
Changes in activity can also help to manage symptoms:
- The person should walk or run on softer and smoother surfaces, and should avoid surfaces like concrete.
- They should stop or decrease any activity that causes them pain.
- They should switch to swimming, biking, or other activities that don’t put as much stress on the Achilles tendon.
A health care provider or physical therapist can demonstrate proper stretching exercises for the Achilles tendon.
The person may also need to make changes in their footwear, such as:
- Placing heel lifts into the shoe beneath the heel
- Using a boot, brace, or cast to keep the heel and tendon stable in order to allow the swelling to go down over time
- Wearing shoes that are softer in the areas under and over the heel cushion
Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin can help ease swelling or pain.
If the treatments listed above don’t improve symptoms, the patient may need surgery to remove the inflamed tissue and abnormal areas of the tendon. If a bone spur is present to irritate the tendon, surgery can remove it and relieve the symptoms.
Extracorporeal shock wave therapy (ESWT) can also be available to some patients as an alternative to surgery if they have not responded well to other treatments. This particular treatment involves the use of low-dose sound waves applied to the area.
Outlook (Prognosis) Of Achilles Tendon Problems
In most patients, lifestyle changes can help to improve symptoms. However, symptoms can return if they do not properly limit their activities that cause them pain, or if they don’t maintain flexibility and strength of the tendon.
Possible Complications
Achilles tendinitis can make the person more prone to an Achilles rupture, which often requires surgical repair. This rupture typically presents as a sharp pain, which the person often describes as being “hit in the back of the heel” with some type of object. The surgery may not be as successful as expected due to the fact that there would already be pre-existing damage to the tendon.
When to Contact a Medical Professional
Contact a health care provider if:
● The person experiences sharp pain in the area and they are unable to walk without extreme pain or weakness.
● The person has pain in the heel around the Achilles tendon area that worsens with activity.
Prevention Of Achilles Tendon Problems
Stretching exercises to keep the calf muscles flexible and strong will help reduce the risk of developing tendinitis. Overusing a tight or weak Achilles tendon can increase the likelihood of someone developing tendinitis. In summary, take careful consideration of the Achilles tendon during strenuous types of exercise.
