You can feel your Achilles tendon beneath the skin on the back of your ankle. It is a fibrous band of tissue that connects your calf muscles to your heel bone (calcaneus), which allows you to lift your heel off the ground. Most commonly an overuse injury, the term Achilles tendinitis commonly refers to, acute inflammation in the sheath surrounding your tendon, chronic damage to the tendon itself, called tendinosis, a combination of the two. Achilles tendinitis can range from mild inflammation to, in rare cases, a tendon rupture. One type of tendinitis, called insertional Achilles tendinitis, can affect the end of the tendon where it attaches to your heel bone. Achilles tendinitis also can be associated with other foot problems, such as painful flat feet.
Most common in middle-aged men. Conditions affecting the foot structure (such as fallen arches). Running on uneven, hilly ground, or in poor quality shoes. Diabetes. High blood pressure. Certain antibiotics. ?Weekend Warriors?. Recent increase in the intensity of an exercise program. While Achilles tendinitis can flare up with any overuse or strain of the Achilles tendon, it most often affects middle-aged men, especially if they are ?weekend warriors? who are relatively sedentary during the week, then decide to play basketball or football on Saturday. Those with flat feet or other structural conditions affecting their feet tend to put excess strain on the Achilles tendon, increasing their chances of developing Achilles tendinitis or even rupturing the tendon. If you are a runner, be sure to only run in quality running shoes that are supportive and well cushioned, and to be mindful of the surface you?re running on. Uneven surfaces and especially hilly terrain put additional strain on your Achilles tendon and can lead to the condition.
People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture.
If Achilles tendonitis is suspected, avoid any exercise or activity that causes the pain. It is advisable to see a doctor promptly so that an accurate diagnosis can be made and appropriate treatment recommended. The doctor will take a full medical history and will ask about the nature and duration of the symptoms. They will perform a physical examination of the affected area. Ultrasound scanning may be used to assess damage to the tendon or surrounding structures. Occasionally MRI (magnetic resonance imaging) may be recommended. The symptoms of Achilles tendonitis are often similar to symptoms of other conditions such as partial Achilles tendon rupture and heel bursitis. This can make diagnosis difficult and a referral to an orthopaedic specialist may be required in order for an accurate diagnosis to be made.
Treatment of Achilles tendonitis begins with resting the tendon to allow the inflammation to settle down. In more serious situations, adequate rest may require crutches or immobilization of the ankle. Learn more about different treatments for Achilles tendonitis, including ice, medications, injections, and surgery.
Your doctor may recommend surgery if, after around six months, other treatments haven?t worked and your symptoms are having an impact on your day-to-day life. Surgery involves removing damaged areas of your tendon and repairing them.
Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain an adequate level of fitness for your sport, avoid dramatic increases in sports training, if you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse, wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses, avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury, maintain a normal healthy weight.