Achilles Tendinitis: Causes and symptoms and how to prevent It

What is Achilles tendinitis?

Before we discuss Achilles tendinitis, we need to know about the Achilles tendon. The Achilles tendon is a connective tissue that connects calf muscles to the heel bone at the back of your leg. You use the Achilles tendon to walk, run, jump and stand on the balls of your feet. If this tissue is overused, it leads to Achilles injury, also known as Achilles tendinitis. 

It is observed that Achilles tendinitis, or Achilles tendonitis, occurs in athletes who have suddenly increased their practice session time. It is also common in middle-aged people who often play tennis or basketball. 

Types of Achilles tendinitis

There are two types of Achilles tendinitis:

a. Noninsertional Achilles tendinitis:

In this type, minute tears are observed in the fibres of the middle portion of Achilles tendinitis and are common in younger adults who are physically active.

b. Insertional Achilles tendinitis:

In this type, the lower tendon attached to the heel bone is affected and recurrent in people of any age group.

Achilles tendinitis causes

Achilles tendinitis appears due to the regular stress on the tendon. It happens when we push our bodies to the extreme. Some other causes are

• A sudden increase in exercise activity: Without giving the body a chance to adjust to the new regimen, you observe a sudden increase in physical activity.
• Tight calf muscles: Tightness in the calf muscles can put extra stress on the tendon, causing Achilles tendinitis.
• Haglund’s deformity: A Condition in which an enlargement of the bone of the back of the heel causes inflammation and pain.

Risk factors

Several factors increase the risk of Achilles tendinitis:

• Sex: Men are more prone to suffer from Achilles tendinitis
• Age: More the age more you are prone to suffer from Achilles tendinitis
• Medical conditions: People with psoriasis and high blood pressure are at high-risk
• Excess weight: If your weight is not within the limit, it puts extra stress on your tendon, putting it at risk for damage
• Improper footwear: Using torn-out or damaged shoes while running can cause damage to the tendon,
• Improper or inadequate exercise: Performing improper or inadequate exercises in the absence of a trainer may put your tendon at risk

Achilles Tendinitis Symptoms

Some of the common symptoms include:

• Severe pain in the Achilles tendon a day after an intense exercise session
• Sore Achilles tendon or swollen Achilles tendon in the morning.
• Thickening of the tendon
• Bone spur formation
• Swelling of Achilles tendon that worsens as the day progresses

If you experience any of the above symptoms, please consult your healthcare professional immediately.

Diagnosis

1. X-ray examination

X-rays provide clear evidence of the presence of bone spurs, if there are any, at the back of the heel, which may present in patients with insertional Achilles tendinitis. X-rays show calcification in the middle portion of the tendon in severe cases of non-insertional Achilles tendinitis. X-rays are helpful for both types of Achilles tendinitis and are most preferred in diagnosis.

2. Magnetic resonance imaging (MRI)

An MRI shows the severity of damage to the tendon, based on which your doctor may proceed with the management route. If the non-surgical treatments are not giving results. In that case, doctors use MRIs to plan the surgery based on the severity of the damage, even though they do not prefer them for diagnosing Achilles tendinitis.

3. Ultrasound

Ultrasound is gaining popularity among healthcare professionals because of its advantages like quick results and low expense when compared to MRI. It is operator friendly and requires less training. You need to note that the operator’s experience solely determines the accuracy of results from ultrasound.

Treatment 

Management of Achilles tendinitis depends on the severity of your signs and symptoms, based on which your doctor may suggest the following:

1. Medication 

There is no exact medicine for Achilles tendinitis since it’s an injury to the tendon, but the pain and swelling can be relieved by medications like ibuprofen or naproxen. If the pain is more debilitating, the doctor may inject corticosteroids like methylprednisolone, or cortisone to provide rapid relief. Patients with heart disease and kidney damage should consult a doctor before taking the aforementioned medicines. 

2. Physical Therapy 

Your doctor might suggest stretching and strengthening exercises to promote healing along with medication. Exercise and stretching are considered a gold standard in the management of Achilles tendinitis, along with other conservative treatments. These exercises and stretchings include tiptoes, bilateral and single heel drops, and strengthening of calf exercises. 

3. Surgery 

Doctors recommend surgery for patients with severe tendon damage that is not healing with conservative treatment. Based on the severity and location of the damage, your doctor may recommend one of the following surgeries. 

• Gastrocnemius recession: It’s a lengthening of the calf muscle to reduce stress on the Achilles tendon and is useful for patients who have difficulty flexing their feet even after sufficient stretching.
• Debridement: In this surgery, the damaged tissue, along with bone spurs from the heel, is removed for patients with insertional Achilles tendinitis. After the surgery, patients can walk with a cast or a removable boot within two weeks. Allowing the activity of patients depends on the severity of damage to the tendon.

Read more- Pulled calf muscle pain treatment

Preventions 

• Increase your exercise activity gradually
• Avoid activities that cause sudden stress on your tendon 
• Always support your feet with proper shoes while exercising
• Stretch daily to get muscles used to exercise 

Conclusion 

You can manage Achilles tendinitis if you treat it properly, and symptoms usually go away after a few days of rest and proper care at home. However, even after proper care, if symptoms linger, then you should consult your healthcare professional. You can get free teleconsultation from our expert doctors once you order medicine on our online pharmacy – Truemeds, or you can also download our Truemeds app. You can avail of branded and generic medication by uploading your prescription on Truemeds. When placing an order for medicines online, you may save more money by selecting alternative or generic medicine advised by Truemed’s expert doctors. You can also save up to 72% on your purchase and get free home delivery* pan India.

Frequently asked questions

Disclaimer: The information given in this article is true to our best knowledge, but we recommend you consult your doctor before taking the medications mentioned in this article.