What is Achilles tendonitis?
Your achilles tendon is a continuation of two muscles that attaches to the back of your foot just above the heel. When there is increased activity in a short amount of time, the connection between the tendon and heel bone can become irritated. This often leads to sharp stabbing pain in the back of the foot. If left untreated for a long time, the condition becomes chronic and may become debilitating.
Who gets it the most?
There is a wide demographic of people who are affected by achilles tendonitis. Young athletes such as basketball players and dancers who routinely perform ballistic movements are prone to injury. Sedentary kids who suddenly start physical activity are commonly affected as well.
What are the symptoms?
In less severe cases, patients will experience stiffness and achiness first thing in the morning that progressively improves throughout the day with walking. In more severe cases, there is sharp stabbing pain with exercise and movements like walking uphill or up stairs. Often you’ll find swelling or even a small bump around the achilles tendon area. In addition to pain, you may find achilles tendonitis to be associated with a tight calf muscle that may cause the patient to walk on their toes to avoid exacerbating any symptoms.
How do we test/diagnose?
There are many conditions that can mimic achilles tendonitis including a complete rupture of the achilles tendonitis. It is important to see a doctor to determine the exact cause of pain. There you’ll be put through several tests which include a gait analysis. Imaging can be used to help discover any other tendon tears and bone injuries. An X-Ray may reveal calcifications in the tendon or avulsions and fractures of the heel bone. Ultrasound can give us a closer look at the soft tissue and whether there is any edema or thickening of the heel cord. MRI is best to visualize extent of any tendon injuries.
How do we treat? surgical/nonsurgical?
Rest from the inciting exercise or activity is the first step to treating Achilles tendonitis. Next is to decrease any inflammation using icing, immobilization in a protective boot, and anti-inflammatories. Custom orthotics are very useful for realigning the foot in a position where it is not overworking any ligaments or tendons. At home exercises to stretch out the calf muscle are highly recommended to supplement the other treatments. Surgery is rarely needed unless all other treatments have been exhausted.
How do we prevent?
Prevention is the number one treatment. It is important to routinely be active so that sudden activity does not aggravate any muscles or tendons. Daily stretches of the calf muscle will keep the tendon flexible. Custom orthotics may be beneficial to assist in walking more efficiently without stressing out surrounding body parts such as the achilles tendon.