The Achilles tendon is the largest tendon in the human body and it can withstand forces of 1,000 pounds or more. But, despite its high-tensile strength, it is also the most frequently ruptured tendon. When the Achilles tendon becomes inflamed or overused, the result is a painful condition that’s known as Achilles tendonitis and it is something that both professional and weekend athletes can suffer from.
What Causes Achilles Tendonitis?
Achilles tendonitis is a chronic injury that can be brought on by a wide range of physical activities and habits, but it is mostly a result of either a lack of flexibility in one’s calf muscles or simple overuse of the tendon.
When the calf muscle loses its flexibility, the Achilles tendon naturally shortens and thereby the tension in the tendon is increased. Overuse of the tendon is usually attributed to frequently running up hills or stairs, increasing one’s training mileage, or performing a lot of speed running.
Signs and Symptoms of Achilles Tendonitis
In most cases, the Achilles tendon will give the patient advanced warning that this injury may be starting to develop. Early warning signs include a gradual onset of pain in the back of the ankle just above the heel, which can occur at any time but usually after running.
The pain increases during exercise and tenderness and stiffness in the area can be experienced in the morning upon waking, with the symptoms gradually easing up as the tendon stretches and warms up. Other symptoms include a sluggish feeling in the leg and in some cases, mild to severe swelling of the area.
In chronic conditions, small lumps or bumps may be felt when running your hand over the Achilles tendon.
How is Achilles Tendonitis Diagnosed?
The foot and ankle surgeon examines the foot for pain, tenderness, and swelling in the affected area. The flexibility, range of motion, alignment, and reflexes of the foot and ankle are also evaluated. In some cases, the surgeon may order an x-ray, ultrasound, or MRI of the Achilles tendon to help determine whether or not the tendon is damaged or ruptured.
Treatment Options for Achilles Tendonitis
Most cases of Achilles tendonitis can be successfully treated using a variety of conservative treatment methods, including:
- Specialized bandaging of the area to restrict motion of the tendon
- Non-steroidal anti-inflammatory medications
- Resting the tendon
- Physical therapy specially-designed for treating Achilles tendonitis (including stretching, massage, ultrasound and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors)
- Custom-made arch supports (Orthoses)
When is Surgery Needed?
Although most cases of Achilles tendonitis respond very well to the conservative treatments listed above, some cases are more severe and the patient may not receive relief from these techniques or the tendon may in fact be torn. In these situations, your foot and ankle surgeon may recommend surgery to repair the tendon.