Achilles Tendonitis

Achilles tendonitis typically presents with pain and stiffness in the Achilles tendon, which connects the calf muscles to the heel bone. Individuals may experience tenderness and swelling in the tendon, especially after physical activity. Pain may worsen with activity and improve with rest. In severe cases, individuals may have difficulty walking or standing on tiptoes due to pain and limited range of motion in the ankle.

Achilles tendonitis develops primarily due to overuse or repetitive strain on the Achilles tendon, resulting from activities such as running, jumping, or excessive walking. This overloading of the tendon can lead to micro-tears, inflammation, and degeneration of the tendon fibers. Additionally, inadequate warm-up or cool-down routines, poor footwear choices, sudden increases in physical activity intensity or duration, and biomechanical factors like flat feet or high arches can exacerbate tendonitis. Other contributing factors may include age-related degeneration of tendon tissue and underlying medical conditions such as obesity or certain autoimmune diseases.

Diagnosing Achilles tendonitis involves a comprehensive evaluation, including a detailed medical history review and physical examination. During the examination, healthcare providers may perform specific tests to assess tendon strength, flexibility, and integrity. These tests may include the Thompson test, in which gentle squeezing of the calf muscle elicits movement of the foot if the Achilles tendon is intact. Palpation of the tendon for tenderness, swelling, or thickening may also be performed. Imaging studies such as ultrasound or MRI may be ordered to confirm the diagnosis, assess the extent of tendon damage, and rule out other potential causes of heel pain or tendon dysfunction.

Treatment options for Achilles tendonitis focus on reducing pain, inflammation, and promoting tendon healing. Initially, conservative measures such as rest, ice therapy, and nonsteroidal anti-inflammatory drugs (NSAIDs) may be recommended to alleviate symptoms and reduce swelling. Physical therapy exercises to stretch and strengthen the calf muscles, as well as eccentric strengthening exercises targeting the Achilles tendon, can help improve flexibility and tendon function. Orthotic devices, such as heel lifts or arch supports, may be prescribed to correct biomechanical issues and reduce strain on the tendon.

Surgery may be necessary in refractory cases or for individuals with severe tendon damage, involving procedures like tendon debridement or repair to restore tendon function.