Achilles tendonitis is a nuisance faced by many runners. When left untreated, it can become chronic and sideline runners for months at a time. The Achilles tendon is a large fibrous band of tissue that connects the large calf muscle to the heel bone. It provides the power behind push-off in any gait, walking or running. In many cases, this condition can be treated with persistence and simple strategies at home.
Causes
There are a number of factors that can contribute to tendonitis in the Achilles tendon. Doctors at the Mayo Clinic warn that it if an athlete increases the distance or speed of a running program rapidly, adds intensive running or stair climbing, exercises without warming up or begins a new exercise regimen after a long period of not exercising regularly, the Achilles tendon can become inflamed and swollen. Runners will find that poor flexibility in the calf muscles, running on an uneven or hard surface and wearing shoes that are worn out or inappropriate, will also place added stress on the Achilles tendon. Athletes who have naturally flat arches or who have slight variations in the foot, ankle or leg anatomy can place more strain on the Achilles tendon. Athletes who participate in a sport that requires jumping or sudden starts and stops are at greater risk of developing Achilles tendonitis.
Symptoms
The U.S. National Library of Medicine lists symptoms of Achilles tendonitis to include pain in the heel when walking or running, as well as a tendon that is painful to touch. The skin over the tendon may become swollen and warm.
Diagnosis
According to the University of Maryland Medical Center, during an examination, physicians look for tenderness along the tendon and attempt to elicit pain in the area by asking patients to stand on their toes. If there is any question that permanent damage, tearing or rupture may have occurred, imaging studies may also be recommended. An MRI will show inflammation in the tendon, and an x-ray will help to diagnose any concurrent arthritis that may be present in the ankle joint.
Treatment
According to the U.S. National Library of Medicine, treatment recommendations often revolve around rest, ice, compression and elevation. Physicians may prescribe nonsteroidal anti-inflammatory drugs to help decrease inflammation in the tendon and relieve pain. Athletes should not go back to physical activity that requires intense use of the Achilles tendon until pain subsides and the physician releases them for activity. On occasion, the physician may also recommend a cast or boot to keep the heel from moving and allow the swelling to go down. Physical therapy may be used after the pain has subsided to reduce the chance of recurrence. If these treatments fail to provide improvement in symptoms after a number of months then the physician may recommend surgical intervention to remove the inflamed tissue and abnormal areas within the tendon.
Prevention
Preventing Achilles tendonitis is important because the tendon will not always return to its prior functioning level once inflamed and scarred. According to Mayo Clinic, athletes should increase their activity level gradually, choose shoes that provide adequate cushioning for the heel and a firm arch support, replace shoes that show excessive wear, stretch daily, strengthen the calf muscles and cross train with low impact activities in order to reduce stress on the Achilles tendon.
