December 2, 2008

ENCYCLOPEDIA

Achilles Tendonitis

Definition

Achilles tendonitis is an inflammation and/or degeneration of the Achilles tendon. The Achilles tendon connects the calf muscles to the heel bone.

Achilles Tendonitis

Achilles Tendonitis

© 2008 Nucleus Medical Art, Inc.

Causes

The Achilles tendon can become irritated for several reasons including:

  • Increasing your speed or running long distances too quickly
  • Suddenly adding strenuous hills or stair climbing to your exercise routine
  • Doing too much too soon after taking time away from exercising
  • A sudden or violent contraction of the calf muscles, such as during an all-out sprint
  • Running too much (overuse)
  • Lack of flexibility of the calf muscles

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

  • Improper or badly worn footwear
  • Improper warm-up for your activity
  • Inflexibility of the calf muscles
  • Improper cool-down
  • An improper training program

Symptoms

Symptoms may include:

  • Tenderness usually located one to two inches above the point where the Achilles tendon attaches to the heel bone (noticeable in the morning upon rising)
  • Stiffness that gradually eases as the tendon is warmed-up
  • Pain after activity that gradually worsens
  • Radiating or localized pain along the tendon during and/or after running
  • Swelling in the area of the Achilles

Diagnosis

The doctor will ask about your symptoms and exercise habits, and perform a physical exam.

Tests may include:

  • X-rays —to see if there is calcium in the tendon
  • MRI scan —to view areas of interior damage to the tendon

Treatment

Rest

Take a break from the activity that caused the tendonitis. Switch to an activity, such as swimming, that doesn't put stress on the tendon.

Orthoses

You may be advised to wear a shoe insert that will place your foot in the correct position for walking and running.

Physical Therapy

  • Stretching
  • Massage
  • Ultrasound
  • Strengthening exercises

Medications

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease the pain and decrease inflammation. This is not curative and must be combined with other treatment.

Prevention

To decrease your chances of getting Achilles tendonitis:

  • Take the time to warm-up and cool-down properly.
  • Wear appropriate footwear for your sport.
  • Do not use shoes beyond the recommended duration. This will depend on:
    • How frequently you exercise
    • The surface on which you exercise
    • The conditions in which you exercise
  • Gradually add hill work, stairs, speed, and distance to your exercise routine.
  • Stretch and strengthen the calf muscles regularly.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org

American Orthopaedic Society for Sports Medicine
http://www.aossm.org/tabs/Index.aspx

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Canadian Orthopaedic Foundation
http://www.canorth.org/

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ .

Mayo Clinic Health Letter website. Available at: http://healthletter.mayoclinic.com/ .



Last reviewed October 2007 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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