What is Achilles Tendonitis?
The Achilles tendon runs from the calf muscles (gastrocnemius, soleus and plantaris) and inserts onto the back of the heel bone. Although it is the largest tendon in the body measuring approximately 6cm in length, it is prone to inflammation due to overuse and degeneration. Tendonitis refers to inflammation of a tendon, hence Achilles tendonitis would suggest inflammation of the Achilles tendon.
There are two types of tendonitis based on the area of injury
- Insertional Achilles Tendonitis: this involves the lower part of the tendon and it occurs directly at the site of insertion onto the heel bone. This type usually occurs due to years of overuse. However, it can occur at any time and can also occur in patients who aren’t active.
- Non-insertional Achilles Tendonitis: this occurs about 2-6cm above the insertion of the tendon and it involves the middle portion of the tendon. The fibers in the tendon begin to breakdown, degenerate and swell.
This condition usually occurs due to repetitive stress to the tendon over time. It can also arise if there is any sudden increase in the amount of intensity of exercise. Having tight calf muscles may cause a strain on the tendon. Also, a bone spur, which is an extra growth on bone on the heel bone where the tendon inserts, can rub on the tendon and cause inflammation and pain.
- Swelling along the tendon or at the back of the heel bone
- Pain in the middle of the tendon (non-insertional tendonitis)
- Pain at the back of your heel (insertional tendonitis)
- Limited range of motion at the ankle, especially flexion of the ankle
Treatment and prevention
Athletes should carry out a stretching programme to properly warm up the muscles before any physical exercise
Icing the area can help to relieve some inflammation. The area should be iced for 20 minutes with a break halfway through. Ice should not be directly applied to the skin. This can be avoided by wrapping the ice in a towel.
A podiatrist can issue a heel raise to help relieve the pressure being placed on the tendon
An orthotic device can be used to control excess motion, support the arch of the foot, and reduce stress on the Achilles tendon.
Stretches for the calf muscles and hamstrings may be issued to help stretch out the muscles and help relieve strain on the Achilles’ tendon
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