Achilles tendinitis may occur when overuse or to much strain is placed onto the tendon in the ankle region. The Achilles tendon is situated at the heel of the foot and connects the lower leg muscles of the calf to the heel bone of the ankle.
This pathology is mainly sustained by people who do a lot of running and high intensity exercises. Individuals who may have amplified the time and intensity of their runs, thus potentially leading to Achilles tendinitis. This injury could also occur with a lot of people who play sports such as tennis, netball or basketball, due to the fast pace and explosive movements, causing added pressure onto the ankle joint. If not treated correctly Achilles tendinitis could lead to further complications such as tendon tears or ruptures, which may require surgical repair.
Anatomy
The Achilles tendon, also known as the calcaneal tendon is situated at the back of the ankle. It is a hard band of fibrous tissue that attaches the calf muscles to the calcaneus (heel bone of the ankle). The Achilles tendon is also the largest and strongest in the body.
The two calf muscles; the gastrocnemius and soleus form into one band of tissue, which becomes the Achilles tendon at the lowest point of the calf. A bursa (small sac of fluid) covers the Achilles tendon to help support and protect the area.
When we flex the calf muscles the Achilles tendon pulls onto the heel. This enables us to perform day to day movements such as walking, running and standing on our tip toes. So, it is important to be safe when exercising ensuring the area is protected. The tendon has a limited amount of blood supply, so when we place the tendon under strain or tension it can be more susceptible to injury.
Causes
The main causes for Achilles tendinitis are from repetitive stress and tension placed onto the tendon, it is not usually related to one specific injury cause. Too much pressure on our bodies sometimes can be harmful and extra care should be taken whenever performing any sporting event or exercise activities. Here are some causes of Achilles tendinitis:
- Tightness in calf muscles
- Sudden increase in intensity of exercise
- Longer duration of exercise
- Unexpected bone growth
Symptoms
Common signs and symptoms of Achilles tendinitis are as follows:
- Stiffness at the back of the ankle first thing when you wake up
- Pain along the back of the tendon
- Sharp pain along the back of the foot
- Feels different e.g., thicker or tighter
- Lack of range of movement
- Severe pain after exercising
- Swelling around the tendon
When exercising or walking and you feel or hear a loud popping noise, you should see your doctor immediately. As it is highly likely that you may have torn/ ruptured the tendon and will need medical attention.
Diagnosis
If you feel you are suffering with Achilles tendinitis, then it is best you go and see your doctor. The health care professional will palpate (feel) the area to determine the site of pain tenderness and swelling. The doctor will also complete a physical examination assessing flexibility, alignment, reflexes and range of movement around the effected area.
Special imaging test may also be used such as:
- X-Rays
- Magnetic Resonance imagining (MRI)
- Ultrasound
Treatment
Now days there are many treatment theories available for Achilles tendinitis. These could be home treatments, anti-inflammatory medication or surgery.
- Use the RICE acronym- Rest, Ice, Compress and Elevate the area of injury
- Reduce physical activity until swelling and pain has reduced
- Ice the area after exercising when pain has occurred
- Anti- inflammatory drugs such as aspirin or ibuprofen (however this may just mask the pain)
- See a sports therapist / physiotherapist for rehabilitation exercises and stretches
- Wear protective equipment such as a brace to prevent heel movement
- See a sports therapist and get a sports massage to ease the tension from the calves and plantar on the achilles tendon.
Exercises
Here are a few exercises which may aid in preventing Achilles tendinitis:
- Calf Raises on Floor
- Stand with feet hip-width apart.
- Slowly lift your heels off the ground, then lower them back down. This strengthens the calf muscles and tendon.
- Single Leg Calf Raises
- Stand on one leg.
- Lift your heel off the ground, then slowly lower it. This targets each calf individually and enhances strength and stability.
- Calf Raises on Elevated Bench
- Stand with the balls of your feet on the edge of a step or bench.
- Rise onto your toes, then lower your heels below the step level. This increases the stretch and strengthens the calf muscles more effectively.
- Lunge Calf Stretch
- Step one foot forward into a lunge position, keeping the back leg straight and heel on the ground.
- Push your hips forward to stretch the calf muscle of the back leg.
- Resistance Band Calf Stretch
- Sit with your leg extended and a resistance band looped around the ball of your foot.
- Pull the band towards you while keeping your leg straight to stretch the calf muscle.
- Resisted Plantarflexion
- Sit with your foot flexed and a resistance band around the ball of your foot.
- Push your foot down against the band, then slowly return to the starting position. This strengthens the calf muscles and tendon.
- Walking on Tip Toes
- Walk around on your tiptoes for a few minutes. This exercise helps to improve calf strength and flexibility.
Prevention
It may not be possible to full prevent Achilles tendinitis from occurring, however you can incorporate certain measures to reduce the risk factors:
- Don’t over do exercise, make sure to have rest days and include full warm ups before exercising
- Increase intensity levels of exercise progressively
- Make sure you are wearing the correct footwear
- Stretch daily, and even more importantly before and after exercising
- Perform specific exercises to strengthen the calf muscles
- Complete non weight bearing exercise such as swimming to reduce pressure onto the Achilles tendon.
If you think you may have achilles tendinitis or would like to find out if you have it, please contact a member of our team today or make a booking online.
