Achilles Tendinitis

What is Achilles Tendinitis?

Achilles Tendinitis, or tendinitis of the heel, is a condition that occurs when the Achilles tendon becomes irritated and inflamed. Crucial for walking, running, and jumping, the Achilles tendon is a flexible tissue chord connecting the calf muscle to the heel bone. A rupture to this small yet significant part of the body results in pain near the bottom of the foot and a swollen heel.

One of the most commonly occurring tendon ruptures, Achilles tendinitis is known to impact males between the ages of 20-39 at the highest rate.

Causes

The most common cause of Achilles tendinitis varies based on the age of the patient. In young people, overuse of the tendon seems to be the prevailing cause. For those approaching middle age and beyond, arthritis is the most common culprit.

Wearing unsupportive footwear is a surefire way to add unnecessary stress to the Achilles tendon. Appropriate shoes are extremely important to reducing your risk of injury; footwear that is worn out should be replaced with something that provides ample support.

Forceful and sudden bursts of activity can result in a ruptured Achilles tendon, which is why “warming up” before a workout is doubly important.

Signs and Symptoms of Achilles Tendinitis

Experiencing pain along the heel and tendon is perhaps the most common symptom of Achilles tendinitis. Discomfort usually occurs near the bottom of the foot and during physical activities such as walking or running. Additional symptoms may include swelling, stiffness, and warmth. Difficulty performing a digitigrade locomotion - also known as standing on your “tippy toes” - is also a common symptom of Achilles tendinitis.

Risk Factors

Recognizing high-risk patients allows medical professionals to recommend strategies that will prevent injury to the Achilles tendon.

Several medical conditions like psoriasis, high blood pressure, and obesity may increase your risk of developing Achilles tendinitis. Other risk factors include poor form during physical activity, age, and even gender. In fact, men are five times more likely to experience an Achilles tendon rupture.

Antibiotics like Cirpo or Levaquin may also increase your risk. Additionally, steroid injections intended to decrease inflammation can weaken tendons, further escalating the possibility of a rupture.

Prevention Methods

There are several ways to reduce your risk of developing Achilles tendinitis. Incorporating simple habits - like a stretch routine - into your daily healthcare regimen will help to promote healthy tissue, muscle, and bone.

New sports and/or physical activities should be introduced gradually. For example, the strategy of a novice runner should not be to tackle as many miles as possible on day one. Instead, training should be centered around realistic distance goals with ample time set aside for recovery. If the activity triggers pain in the tendon, it should come to an immediate halt.

Cross-training, or alternating high-impact activities with low-impact activities, is another great way to lower your risk of developing Achilles tendinitis. Focus on calf-strengthening exercises to provide extra support and avoid overextending the tendon.

In many cases, Achilles tendinitis can be treated with a self-care regimen, so long as it is under the close supervision of a medical professional. On the other hand, more serious cases that go untreated can result in tendon tears that will eventually require surgical intervention.

Surgical Treatment Options

Often an outpatient procedure, an orthopedic surgeon performs surgical treatment of Achilles tendinitis. One should take proper care in choosing a medical professional who has ample experience and the knowledge, team, and expertise to perform a successful surgery.

For the first few days following surgery, the leg should remain elevated for as long as possible to combat any swelling. Pain can be treated with prescription and over-the-counter medications. Patients are likely to use crutches after surgery to keep weight off the leg.

About two weeks after surgery, stitches will be removed and the patient will be provided with a cast or boot. The surgeon will advise on when it is okay to place weight on the leg. In some cases, physical therapy will be recommended during the recovery process.

Nonsurgical Treatment Options

So long as a proper self-care strategy is in place, it is indeed possible to repair an Achilles tendon without surgery. The acronym R.I.C.E. provides the necessary steps to kickstart your recovery: rest, ice, compression, and elevation.  Rest includes avoiding any strenuous physical activity for several days. Ice should be applied to the tendon fifteen minutes following an exercise routine or whenever pain is experienced. Compressive wraps or elastic bandages should be used to help reduce swelling and tendon movement. Lastly, the affected foot should be elevated to a level above the heart throughout the day and while sleeping at night.

Patients should keep in mind that nonsurgical treatment results in a slightly higher chance of re-rupture.

To learn more about Achilles Tendonitis treatment options in the Fort Myers area, contact the Institute for Orthopaedic Surgery and Sports Medicine.