The Achilles tendon is the largest and the most powerful tendon in the human body. It’s positioned between the calf muscles and the heel bone. The tendon translates the mechanical power of the calf muscles to the heel and enables the downward movement (plantar flexion) of the foot or toes. Movements like running, walking and jumping are possible because of this. Although the Achilles tendon is the strongest, it is susceptible to tendinitis.
What is Achilles Tendinitis
Excessive strain on the tendon due to intense physical pursuits can cause inflammation of the tendon along with pain at the back of the ankle, says Dr Vijay Kumar Sohanlal – a highly experienced orthopaedic surgeon. As a senior specialist in joint replacement and orthopaedics at MGM healthcare and Mahi Clinic – Chennai, he has been successfully treating patients for over a decade. He says that if you begin doing too much too soon, like suddenly going for an intense run without much practice, you may injure your tendon.
The Achilles tendinitis is of two types:
Insertional Achilles Tendinitis
A condition when Achilles tendon fibres degenerate near the back of the heel, where the tendon attaches to the heel bone is called Insertional Achilles tendinitis. It’s usually associated with tenderness at the back of the heel bone. This tendinitis is not related to a specific injury. It occurs due to overuse of the tendon over extended periods and can affect people who are not very active when this occurs.
Noninsertional Achilles Tendinitis
A condition when the fibres in the middle of the Achilles tendon degenerate is called noninsertional Achilles tendinitis. There are small tears in the tendon causing swelling and thickening. Usually, younger and active people tend to get affected by this condition.
Causes of Achilles Tendinitis
The tendinitis usually results from overuse of the tendon. Repetitive stress from intense exercising often leads to the condition. Sometimes when you push yourself too much and overdo some physical activity within a short period, too much stress on the tendon can lead to the condition. Here are some of the causes that Dr Vijay Kumar detailed for us:
- Footwear plays an important role and poor footwear choice for running or exercising can cause tendinitis. Worn out and misfit shoes must be replaced. Running on hard surfaces without footwear must be avoided.
- The physical structure of the feet may also affect the tendons. The tendon may experience more strain if the foot has a flat arch. If the calf muscles are tight and a sudden intense workout is done without warm up, it can be problematic. Obesity also adds to the problem.
- Sometimes bony projections (bone spurs) are formed near bone and tendon joints. Such projections rubbing against the tendon at the back of the heel can cause damage.
- Men are more likely to suffer from this condition.
Some of the symptoms of the condition are:
- Pain or swelling at the back of the heel or along the tendon
- Stiffness of the calf muscles, usually on the next day after the activity
- Difficulty in flexing the foot
Treatment of Achilles Tendinitis
Dr Vijay says that if there is no improvement in pain then it’s important to get diagnosed by an orthopaedic specialist. Depending on the severity of the condition, non-surgical or surgical treatment is provided.
Non-surgical treatment includes R.I.C.E (rest, ice, compression, and elevation) method along with anti-inflammatory medicine may bring some relief. Physical activity must be reduced and some gentle stretching exercises of the calf muscles must be done. Your doctor may recommend a brace or shoe with built-in support for the heel. In some cases, surgical treatment may be required. There are various surgical options and the specialist decides the best treatment in any given condition.