Achilles tendinitis is a rather common condition among athletes and is caused by overuse of the affected limb. The Achilles tendon is able to withstand significant stress from jumping and running, but is prone to tendonitis. There are two types of Achilles tendinitis. The first is non-insertional Achilles tendinitis. The second is called insertional Achilles tendinitis. The classification depends on which part of the Achilles tendon is irritated and inflamed; in the former, the middle part of the tendon is affected, while in the latter, the lower portion of the heel (where the heel bone and tendon are attached) is affected. Pain usually begins as a mild, dull ache above the heel or in the back of the leg after a sports activity (or any kind of running). Pain may become severe after sprinting, stair climbing, or prolonged running. There may also be stiffness or tenderness in the area (especially in the morning), though this usually disappears after mild activity.
Occurrence
Achilles tendinitis is caused by undue strain placed upon the Achilles tendon, which is a stretch of tissue that connects your heel bone to your calf muscles. This strain can be either intense, or simply repetitive. This is a vital tendon to athletes, as it is used when you push up on your toes, jump, run, and walk. The support structure of an Achilles tendon usually weakens as you grow older, making it far more likely to acquire an injury. Achilles tendinitis can be caused by a sudden increase in the intensity, duration, or frequency of exercise activity; for example, increasing how far you run each day without allowing your body to adjust to the previous distance. Tight calf muscles can also lead to Achilles tendinitis, as they put extra stress on the Achilles tendon. Additional bone growing where the heel attaches itself to the Achilles tendon (called a bone spur) can also result in Achilles tendinitis. This is because it rubs the tendon creating some severe discomfort.
Treatment
Achilles tendinitis usually responds well to at-home treatment and self-care measures. If your symptoms are persistent or severe, however, your doctor may recommend other treatment methods. They may prescribe stronger medication, for example, to relieve pain and reduce inflammation if over-the-counter pain medications are not working. The first step to reducing pain is stopping any activity that causes the pain or discomfort to increase. If the pain increases while running, it is vital to stop running. If you want to continue exercising, try switching to a low-impact activity such as swimming. This will reduce the stress on the Achilles tendon and help improve the condition. You should also ice the most painful area for 20 minutes at a time throughout the day. Make sure the ice pack is wrapped in a thin towel to avoid skin damage. For high level athletes, cortisone injections may be administered. If the pain does not go away after 6 months, surgery may be required. The type of surgery depends on the amount of damage in the tendon and the location of the tendinitis.
Recovery
The recovery time for Achilles tendinitis varies depending on the severity of the injury and how it responds to treatment. It may heal in a few weeks with self-treatment. If it requires surgery, however, it may take 3-4 months to entirely heal. Your physical therapist may recommend exercises (such as bilateral heel drop and a calf stretch) to strengthen and stretch the tendon and its supporting structures. Your doctor may also recommend that you wear orthotics and supportive shoes to reduce tendon irritation. Although preventing Achilles tendinitis is not entirely possible, it is possible to reduce your risk. Gradually increase your activity level, and avoid activities (such as hill running) that place extra stress on your tendons. Stretch daily – in the morning and before and after exercising. You should also cross-train and do exercises that strengthen your calf muscles. The American Academy of Orthopaedic Surgeons has more information on Achilles tendinitis.
