What is Achilles Tendinitis?

The Achilles tendon, the strongest tendon in the human body, attaches the calf muscle and the heel bone. As a result of overuse or traumatic injury, this tendon may become inflamed, leading to a condition called Achilles tendinitis or Achilles tendinosis. This ankle injury can be treated with rest, medication, and physical therapy.

The strength of the Achilles tendon makes it an important source of power during exercise, particularly in running. The movement of this tendon is what provides the “push” when the foot lifts off the ground during running and walking. Because the tendon exerts a large amount of force, it is highly sensitive to overuse; in fact, Achilles tendinitis is thought to be responsible for around 10% of running injuries. Athletes who play sports such as basketball and tennis, which involve repetitive foot movement and jumping, are also at increased risk of this type of injury.

Achilles tendinitis is a very painful and debilitating condition; this pain tends to be the defining symptom of the injury. Often the pain is mild initially, and becomes worse over time if the tendon is not rested and allowed to heal. Because the Achilles tendon is so important in walking, the pain of an inflamed tendon can be so severe that walking is severely impaired, if not impossible. If the injured individual continues to put stress on the injured tendon, inflammation may increase to a point where the tendon is so weakened that it ruptures. This injury causes intense, acute pain, and severe damage to the tendon.

In minor cases of Achilles tendinitis, the injury may resolve itself with application of the RICE method of treatment. This includes rest of the injured foot, daily application of ice packs, compression of the foot and ankle to provide support, and elevation of the foot when resting. These measures help reduce pain, swelling, and inflammation to help the healing process. Over-the-counter non-steroidal anti-inflammatory medications can be used to manage pain.

More severe injuries may require prescription pain or anti-inflammatory medication. In addition, the use of a cast or crutches may be necessary to reduce the need to use the injured ankle. Physical therapy exercises are often used to improve the strength and range of motion of the calf muscles and foot, which helps reduce the pressure placed on the tendon. For very severe, chronic tendon injury, or rupture of the tendon, surgery can be performed to reattach torn tendons, or remove scar tissue.

While these treatments are usually effective, the healing of an Achilles tendinitis injury is usually slow and may be problematic. This is because the blood flow to the tendon is very limited, particularly in the mid-portion of the tendon. As a result of reduced blood flow, the tendon is slow to heal and injury is easily exacerbated if an individual begins exercising too soon during the recovery process. Recovering from an inflamed Achilles tendon may take several weeks; if the tendon is ruptured, recovery may take many months.