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What is Achilles Tendonitis?

Dr. Maisie M
Achilles is one of the largest tendons of the body, it helps in the contraction of calf muscles to facilitate movements like walking, running, jumping, climbing and weight-bearing on the toes. Heel pain caused by Achilles tendonitis can worsen if left untreated in the acute stage.
Achilles tendon acquires its name from a Greek mythological story. Achilles was a fearless Greek hero, who became immortal after his mother; Thetis dipped him (holding him by the heel) in the magic waters of Styx. The heel remained vulnerable, and later he had a fatal heel injury in a war.

What is Achilles Tendonitis?

Achilles Tendon is a fibrous band of tissue connecting the calf muscles to the heel bone. It helps transmit the pressure from the lower leg muscles to the foot. Pain and swelling of this tendon is known as Achilles Tendonitis where "itis" means inflammation.

What are the Causes of Achilles Tendonitis?

  • Obesity: Achilles tendon bears thrice the body weight during body movements and being overweight increases the burden manifolds.
  • Overuse trauma: Rapid increase in daily activity with repetitive stress on the feet. Sports persons are at a greater risk of developing tendonitis.
  • Anatomical abnormalities: Flat feet, hyper-pronated arch, frail or tight tendon and calf muscles.
  • Lack of stretching exercises
  • Accidents or foot injury
  • Unsuitable footwear: High heels, shoes without arch support, heel support and cushioning.
  • Arthritis: It being a musculoskeletal ailment, tendinopathy can be sign in addition to other symptoms of joint pain.
  • Medications: Quinolone drugs cause inflammation of the tendon.

What are the Symptoms of Achilles Tendonitis?

  • Pain: Site of pain is above the heel bone at the insertion of Achilles tendon and small region around it. Pain tends to decrease with mild activity after a period of rest. However with increased motion the pain worsens.
  • Swelling: Inflammation causes tenderness, warmth and swelling near the tendon. Occasionally swollen calf can be a symptom.
  • Restricted movements: Due to limitations in plantar flexion of the foot, running, climbing and standing on toes is stressful.
  • Limping: Stiffness and weakness reduces mobility.

How is Achilles Tendonitis Diagnosed?

Diagnosis can be made by examination of feet and ankle. Depending upon the degree of injury the physician may advise MRI scan, X-ray or an ultrasound of the tendon.

What are the Treatment Options of Achilles Tendonitis?

  • Rest: Stay off feet and restrict activity depending upon the severity of pain and injury.
  • Ice compress: Apply ice packs repeatedly for a longer duration.
  • Pain killers: Acute conditions are controlled by proper use of NSAID's, which help reduce pain and swelling.
  • Compression: Elastic bandage is used to wrap the feet and ankle and an elevated position helps reduce swelling.
  • Rehabilitation: Gradual stretching of Achilles tendon and calf muscles help strengthen weight-bearing muscles of lower leg.
  • Proper footgear: Proper fitting shoes with arch supports and heel cushioning will help correct the biomechanics.
  • Weight loss: Losing weight in case of obesity and muscle training is advised to reach a level of optimal fitness.
  • Surgery - Chronic symptoms of Achilles Tendonitis would need surgical intervention to repair the tendon injury.