What is Achilles Tendonitis?
Tendons attach muscles to bones and the Achilles tendon is the largest tendon in the human body. The Achilles tendon attaches the large calf muscles (gastrocnemius and soleus) to the back of the heel bone (calcaneus). You can locate your Achilles tendon by feeling for a large cord-like structure attached to the back of your foot.
The Achilles tendon helps you balance your body while standing, pushing forward during walking or running, and springing upward during jumping. The Achilles tendon is attached to muscles with greater mass and strength than all of the other muscles of the lower leg combined. As a result, the large amount of stress the muscles place on the Achilles tendon makes it prone to injury.
Achilles Tendonitis is the most common form of injury to the Achilles tendon. The injury generally occurs in people who are active in sporting activities. Basketball, tennis, running, football, soccer, volleyball, and other running and jumping sports are common activities that can lead to Achilles Tendonitis.
Who Gets Achilles Tendonitis?
Older athletes are more likely than younger athletes to experience Achilles Tendonitis. As a person ages, ligaments and tendons tend to lose stretchiness and strength, giving older individuals who are active in running and jumping activities a predisposition to injuries such as Achilles tendinitis. Although not as common, Achilles Tendonitis can occur in teenagers who are very active in running and jumping sports.
How is Achilles Tendonitis Diagnosed?
Achilles Tendonitis is diagnosed with a history and physical examination. A common symptom that leads to diagnosis is pain at the back of the ankle with walking and/or running activities. The pain generally occurs if you have increased the frequency or intensity that you have been running or jumping. The pain can also be associated with a change in running shoe (from a thick heeled to thin heeled), such as switching from training shoes to racing flats. The pain is often so severe that it makes running impossible and walking uncomfortable.
What is the Physical Examination Like?
The podiatrist will touch and push lightly around the Achilles tendon to see if it is tender or has any irregularities in its surface. Sometimes Achilles Tendonitis causes a thickening of the tendon that in turn causes the area around the tendon to swell. It may feel like the tendon has a painful bump on it. Someone with Achilles Tendonitis will limp if barefoot, but walk more normally with heeled shoes. While X-rays are not helpful in diagnosing Achilles Tendonitis, your Dallas foot doctor may order them to rule-out other pathologies. If a partial or complete rupture of the Achilles tendon is suspected, your podiatrist may order an MRI scan.
Achilles Tendonitis Treatment
As long as it is diagnosed and treated early, Achilles Tendonitis generally responds well to conservative treatment. Doctors that treat Achilles Tendonitis do not typically resort to surgery unless the case is particularly severe and chronic or if the tendon has completely ruptured.
One of the initial treatments your Dallas podiatrist may choose is putting heel lifts into your shoes. You may also be asked to avoid barefoot walking or walking in low-heeled shoes. Your podiatrist may prescribe non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) and naproxen (Naprosyn, Aleve) to calm the inflammatory process in the tendon. Icing may also be recommended to help decrease inflammation and pain. Stretching exercises may be suggested to help loosen the calf muscle and Achilles tendon to relieve the stress on the tendon during normal daily walking activities. However, it is important not to perform stretches if it causes pain in the Achilles tendon.
A patient with Achilles Tendonitis will be asked to decrease their running and jumping activities and encouraged to practice alternative forms of exercise, such as swimming. Swimming puts less stress on the Achilles tendon. As the tendon improves, your podiatrist will allow you to gradually return to your normal running and jumping activities. If recovery is not possible within a few weeks, then your podiatrist may prescribe physical therapy and/or functional foot orthotics to speed the healing process. Foot orthotics are usually used during sports and walking activities to allow for more normal foot and Achilles tendon function. If your physician is concerned about a partial tendon tear, you may be asked to wear a below the knee cast. Depending on the severity of the injury, the Achilles tendon can take several weeks or months to heal. Returning to your activities too quickly may cause you to re-injure the tendon, so patience and careful monitoring are important.
If you are experiencing these symptoms, request an appointment with us.
Metroplex Foot and Ankle is a progressive group of physicians and surgeons who are committed to helping our patients to achieve their full wellness potential. Contact our Dallas Podiatrist, Garland Podiatrist, or Richardson Podiatrist offices to schedule an appointment today.