Achilles Tendinitis SketchIn the ancient Greek myth, a heroic warrior named Achilles is virtually invincible. Except he has a vulnerability in his heel. He is famously shot by an arrow in his heel, dying as a result. Modern tales of Achilles tendinitis told by weekend warriors aren’t quite as epic—but they are perhaps more relevant. Injuries to the Achilles tendon are quite common, and they can be quite painful. Thankfully, unlike the mythical Greek hero, Achilles tendinitis is treatable and never fatal. Your podiatrist can help you get back on your feet and back in the game in no time.

What Is Achilles Tendinitis?

Achilles tendinitis is one of the most common sports injuries. The Achilles, the primary tendon used in running and jumping, is also the largest tendon in the human body. Also called the heel cord, the Achilles tendon runs from the back of the leg to the heel bone. This fibrous band of tissue is vital for moving around.

Tendinitis is the term used to describe when a tendon gets inflamed. Achilles tendinitis is usually an overuse injury where the tendon gets overworked. The repetitive stress can lead to small tears.

Inflammation and irritation of the Achilles tendon are usually short-lived. However, if the condition is not adequately addressed, it can progress to more severe problems. Inflammation and tears can lead to a degeneration of the tendon, known as Achilles tendinosis. The tendon loses its structure and may rupture.

Common Symptoms of Achilles Tendinitis

The most obvious symptom of Achilles tendinitis is pain. Most people experience discomfort behind or above the heel. It could be a sharp pain. They may also feel a mild ache in the back of the leg. You may notice swelling around the Achilles tendon.

The pain typically worsens during active times. After prolonged running, sprinting, or climbing stairs, you may be hit with bouts of more severe pain. The morning after, you may also feel more of a dull pain, along with tenderness, soreness, or stiffness in the affected area. As the Achilles tendon runs from above the heel to below the calf muscle, you may experience pain and discomfort anywhere in this region.

Symptoms of Achilles tendonitis can vary in severity. Mild cases may only have periodic pain. Moderate cases may include pain and swelling on a regular basis. You may notice a nodule on the back of the heel. In more severe cases of Achilles tendinitis, people may experience chronic throbbing pain. They run the highest risk of a tear or rupture of the Achilles tendon.

Causes and Risk Factors for Achilles Tendinitis

Often, people can experience Achilles tendinitis when they suddenly increase the frequency or intensity of a repetitive activity. Running and playing sports are common examples. The activity puts excessive stress on the Achilles tendon too quickly. The body doesn’t have enough time to adapt and suffers from micro-injuries. With ongoing stress, the body is unable to repair itself.

Common causes of Achilles tendinitis include:

You may be at greater risk of developing Achilles tendinitis if you:

  • Are male
  • Are older in age, as the Achilles tendon weakens with age
  • Are overweight or obese
  • “Weekend warriors” who tend to be de-conditioned
  • Are workers and laborers who put stress on their ankles and feet
  • Have excessive overpronation (flattening of the arch)
  • Have tight calf muscles
  • Are running in cold weather or on hilly terrain
  • Have medical conditions such as arthritis, high blood pressure, or psoriasis
  • Take certain medications, like fluoroquinolones (a type of antibiotic)

Diagnosis, Treatment, and Preventative Measures

If you feel any pain or swelling around the feet, heels, ankles, or lower leg, it’s important to see a podiatrist right away. They can help assess the problem and suggest treatments to get you back on your feet.

To diagnose Achilles tendinitis, your podiatrist will start with a physical exam. They can evaluate your flexibility, alignment, and range of motion. To pinpoint and confirm the condition, they may use imaging tools. Examples include X-rays, ultrasounds, and magnetic resonance imaging (MRI).

Treatment options and preventative measures for Achilles tendinitis often go hand-in-hand. These may include:

  • Rest, ice, compression, and elevation (RICE)
  • Casting or other immobilization techniques, such as removable walking boots
  • Stretching your feet and calf muscles regularly to improve flexibility
  • Wearing the right shoes with firm arch support
  • Night splints to maintain the stretch in the Achilles tendon during sleep
  • Oral medication for pain and inflammation
  • Custom orthotics to help control the motion of your feet
  • Physical therapy, like stretching exercises and soft-tissue massage
  • Warming up at a slower pace before exercising
  • Gradually increasing your activity level rather than sudden increases in intensity
  • Cross-training between higher and lower-impact activities

Many people recover from Achilles tendonitis in about three to four months with the proper care. Visit your podiatrist on a regular basis to assess your progress and reduce the risk of future injury.