Achilles Tendonitis

The Achilles tendon is one of the longer tendons in the human body which stretches from the heel bone to the calf muscles. It appears as a band of tissue at the back of the ankle and above the heel. It is used when you walk, run or jump. It is the largest tendon in the body and can withstand great stresses; however, overuse or degeneration can occur resulting in inflammation called tendonitis or tendinitis.

Achilles tendonitis also called Achilles tendinitis may be caused by a sudden increase in activity which overstrains the tendon, tight calf muscles, and bony overgrowths. It is characterized by pain, irritation, swelling or thickening. Pain or stiffness is usually worse in the morning or after activity.

Tendonitis may affect the part of the tendon inserted in the heel bone (insertional tendonitis) or the middle portion of the tendon (non-insertional tendonitis). Damaged tendon fibers may calcify or harden. Bony overgrowths may form because of tendonitis and irritate the tendon further. Non-insertional tendonitis is more common in young active people while insertional tendonitis may occur in any age group.

Your doctor will review your symptoms and examine your foot and ankle looking for pain, tenderness, swelling, bony overgrowths and loss of range of motion. Imaging studies such as an X-ray or MRI are ordered to identify the calcified or damaged areas of tendon and if necessary to plan surgery.

Achilles tendonitis is first treated conservatively by resting the ankle, applying ice, administering pain and anti-inflammatory medication and strengthening and stretching the calf muscles. Steroid injections may be recommended to reduce inflammation. Special shoes or shoe inserts may help reduce strain and irritation. Pain usually takes a few months to subside. If pain persists longer than 6 months and there is minimal improvement, surgery may be necessary. Surgery depends on the type of tendonitis and the amount of tendon damage and may involve lengthening of the calf muscle, removing damaged portions of tendon or bony overgrowths, and reinforcing the remaining tendon with sutures, bone anchors or nearby tendons.