Achilles Tendonitis

What is Achilles Tendonitis?

The Achilles tendon is a large band of fibrous tissue that stretches along the calf muscle to the heel bone. It is responsible for moving the heel when the calf muscles stretch thus allowing us to stand on our toes during any physical activity. When this tendon becomes inflamed, irritated, or degenerated, Achilles tendonitis develops.

Are there different types of Achilles tendinitis?

There are two types of Achilles tendonitis: insertional and non-insertional.

Insertional Achilles tendonitis affects the lower portion of the Achilles tendon, where it attaches to the heel. Small tears and swelling are typical of this type of Achilles tendonitis and it is common in people with a Haglund’s deformity, a foot condition where the back of the heel is prominent, which causes irritation to the tendon.

Non-insertional Achilles tendonitis is characterized by pain and inflammation of the middle portion of the Achilles tendon. It can result in degeneration of the tissue due to stress and pull of the tendon. Non-insertional Achilles tendonitis is more commonly seen in young, active people.

• Increased physical activity
• High impact activities
• Pre-exiting foot problems
• Abnormal bone growth
• Improper shoes that don’t promote foot health
• Faulty foot biomechanics such as overpronation
• Tight muscles and tendons

• Pain and stiffness along the Achilles tendon or the back of the heel, often most significant in the morning
• Limited foot motion when flexing
• Pain and swelling along the tendon or heel that worsens with activity
• Thickening or swelling of the tendon
• A boney protrusion or bone spur at the back of the heel

• X-rays can show calcification and its location to determine the specific type of Achilles Tendonitis.
• An MRI can show detailed images of the foot and leg and is the best method to diagnose the condition. It can detect tears in the tendon and help prepare for surgery if needed.
• CT Scan
• Physical examination of the foot and its movement.

• Rest your legs and feet. Since Achilles tendonitis is exacerbated by physical activity, resting will do the opposite! The best is to completely stop but reducing activity helps too. Keep watch on which activities increase pain and try to avoid them.
• If you experience Achilles tendonitis pain, you can ice the area. Icing will numb the pain, constrict the blood vessels, and help with the swelling. You can do this as needed throughout the day and after physical activities.
• Stretching the calves can improve flexibility, strengthen the muscles, and decrease strain on the Achilles tendon.
• Shoes for Achilles tendonitis are especially designed to offer comfort and protection. Here are the features of the best Achilles tendonitis shoes:

  • Orthotic insoles support the arch and foot and help alleviate tension on the tendon, easing pain and discomfort.
  • Ergonomic soles provide a heel lift and help reduce strain on the tendon
  • Soft, padded flexible uppers, especially at the back of the heel, cushion the area around the heel and minimize irritation of the tendon.
• If your shoes do not have built in insoles with arch support, purchasing orthotics for Achilles tendonitis is recommended. The orthotics will align the body, prop the arch and decrease the strain on the tendon. Good orthotics are made with several layers to cushion the foot and soften steps.
• Physical therapy. Strengthening exercises, stretches and stress releasing movements can be an effective tool in overcoming pain and stiffness of the condition. Make sure you consult with a licensed professional to guide you.
• Non-steroidal anti-inflammatory medication can help with reducing pain, swelling and inflammation.
• In more advanced cases, immobilization or wearing a medical boot or cast for a few weeks is suggested.
• When all else fails, surgery can help repair the damage and eliminate Achilles tendonitis.

If you have succeeded in treating your Achilles Tendonitis, prevention is key. Making a few simple changes in your every day will minimize the risk of it coming back.

• Exercise in moderation. It is recommended to gradually increase intensity and duration.
• Combine varying exercises to include ones that do not apply pressure on the Achilles tendon. This will allow your Achilles to “rest” on these days.
• Stretch your calves every morning.
• When you engage in physical activities, stretch before and after focusing on the Achilles tendon.
• Run on hard solid surfaces such as concrete, pavement or tracks.
• Wear supportive and quality shoes. Shoes for Achilles tendonitis are ideal.
• Use a heel lift in your shoes to minimize rubbing at the back of the shoe. A lift will also take some train off the tendon.