- Orthopaedic & Neurosurgery Specialists PC (ONS)

The Achilles tendon is the largest tendon in the human body. It is located at the back of the ankle joint and attaches the calf muscles to the heel bone. The Achilles tendon is used to walk, run, jump or push up on the toes. Achilles tendinitis is the inflammation of the tendon and is most often caused by overuse, or is a result of a strain injury.

Aging and sports activities that involve a lot of calf muscle like basketball and tennis have a higher incidence of injury to the Achilles tendon. The injury is also associated with a sudden increase of intensity or frequency of an exercise.

Symptoms of Achilles tendonitis

• A dull ache or pain during activity
• Tenderness, particularly in the morning, above the heel bone
• Stiffness that improves as the tendon warms up
• Mild swelling or a bump

A sudden pain or swelling above the heel and difficulty walking or moving the foot up and down may indicate a rupture of the tendon. As with any injury to the Achilles tendon, it is important to be seen by an orthopedist to determine if it is due to tendonitis or more serious conditions such as a partial tendon tear, heel bursitis or a rupture.

Treatment of Achilles Tendonitis

When treated properly, Achilles tendonitis is usually resolved quickly. When left untreated, it may lead to a more serious condition or tear. Some or all of the following may be used to treat the condition depending on its severity:

• Rest
• Nonsteroidal anti-inflammatory medication
• Orthotics or shoe inserts that help support the muscle and relieve stress on the tendon
• Bandaging to restrict motion
• Physical therapy that includes stretching, massage, ultrasound and strengthening exercises

If friction between the tendon and its covering sheath causes the sheath to become thick and fibrous and conservative treatments are not effective, surgery may be an option. A surgeon can remove the fibrous tissue and repair any tears. A temporary cast may be worn during recovery and a rehabilitation program is usually recommended.

Prevention of Achilles tendonitis

• Choose a running shoe that provides cushion to the heel.
• Walk and stretch to warm up gradually before exercising.
• Stretch and strengthen the muscles in the calf.
• Increase running distance and speed gradually.
• Avoid unaccustomed strenuous sprinting and hill running.
• Cool down gradually after exercise.