The Achilles tendon is one of the largest tendons in the body and connects the powerful calf muscles at the back of the ankle to the foot. It allows normal walking by enabling us to push off the ground. Achilles tendonitis is a common overuse injury seen in both athletes and non-athletes.
The Achilles tendon can be felt at the back of the heel and is important in tiptoeing, walking or running. Achilles tendonitis or inflammation of the tendon can occur anywhere along the tendon. Sometimes a painful lump is felt on the tendon.
- Tight calf muscles.
- Prolonged overuse like in long distance runners.
- Sudden increase in exercise activity or starting to exercise after a prolonged break from activity.
- Prominence of the heel bone in front of the Achilles tendon (Haglund deformity).
Pain at the back of the ankle is the main symptom. This pain is made worse with exercise or activity. There is often a thickening or fullness felt on the tendon. Tiptoeing maybe painful.
For acute Achilles tendonitis, painkillers called non steroidal anti-inflammatory drugs (NSAID) are effective in settling down the inflammation. We encourage short term use only. Ice may also be helpful acutely when applied for short periods.
Rest is also important as the inflammation is made worse if you continue with all the aggravating activities. A period with a heel raising insole or an orthopaedic boot may be beneficial to reduce the load on the tendon.
Compression of the tendon with an ankle support braces may also be effective in easing the symptoms acutely.
After the acute phase, treatment aims at preventing recurrence. Stretching the calf muscles with controlled exercising is necessary and needs to be performed on a daily basis. The Alfredson eccentric stretching technique is simple and is shown in the video above. It may take months for the tendonitis to settle down. If you have persistent pain despite good physiotherapy, a surgical consultation may be required. An MRI scan is likely to aid your further assessment.
- Foot & Ankle
- Anterior Cruciate Ligament Rupture
- Medial Collateral Ligament Tear
- Meniscus Tears
- Osteoarthritis of the Knee
- Patella (Knee Cap) Dislocation
- Patella Chrondromalacia
- Patella Tendonitis
- Posterior Cruciate Ligament Injury
- Acromio-clavicular joint pathology
- Biceps tendinopathy
- Frozen Shoulder
- Instability and shoulder dislocation
- Rheumatoid Arthritis
- Rotator cuff tear
- Scapular Dyskinesia
- Septic Arthritis
- Paediatric Orthopaedics