Achilles tendinitis is inflammation of the Achilles tendon or thick ligament that inserts into the back of the heel.
- Pain and sometimes swelling in the back of the heel or along the Achilles tendon between the heel bone and the calf muscle, and occasionally along the tendon between the heel bone and the calf muscle.
- If the tendon has been chronically inflamed, an area of enlargement of the tendon is often noted.
The causes of Achilles tendinitis are very similar to the causes
of plantar fasciitis. If your foot is unstable, the arch flattens more than it should and the foot moves into an unstable or pronated position, excessive tension is placed on the Achilles tendon with every step that you take. It gets irritated and its attachment is at the back of the heel and inflammation develops over time. A low grade inflammatory response may be present for many years before the onset of pain. This low grade inflammatory response can cause the part of the ligament that attaches to the heel bone to calcify or become bone, leading to the development of a heel spur. Contrary to popular belief, rarely do heel spurs cause pain alone. The pain is almost always directly attributed to the inflammation in and around the tendon.
Like most inflammatory conditions in the foot and ankle, treatment options for Achilles Tendinitis are two-fold. First, get the pain and inflammation under control and secondly, take excessive tension off of the tendon and maintain appropriate stability to the foot and ankle.
Initial treatment may consist of oral and topical anti-inflammatory medications, physical therapy, heel lifts and in severe cases, immobilization in a walking boot. Once the inflammation is under control, mechanical stability is maintained with custom orthotics to prevent excessive stresses to the tendon and maintain optimal function of the foot and ankle. This will help prevent the condition from recurring. Rarely is surgery necessary to address Achilles Tendinitis.