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Achilles Tendonitis

  • What is Achilles Tendonitis?

    The Achilles Tendon is the large tendon in the back of the ankle that connects the calf muscles to the heel bone. These muscles are essential for walking, running and jumping. The Achilles Tendon withstands a great deal of stress during normal daily life. Achilles Tendonitis occurs when the muscles and tendon are overused, causing irritation and inflammation of the tendon.

    There are two types of Achilles Tendonitis:

    • Insertional Achilles Tendonitis, which affects the lower portion where the tendon attaches to the heel. This can occur at any age
    • Non-Insertional Achilles Tendonitis, which affects the middle part of the tendon and there is swelling and thickening in this area. This is most common among young active people

    Hardening (calcification) of the damaged tendon fibres can occur in both types of Achilles tendonitis.

  • Achilles Tendonitis is usually caused by continuous stress (a repetitive minor impact) on the affected area or from a sudden injury. Poor stretching or conditioning before exercise or playing sports also increases the risk. Achilles Tendonitis may be more likely to occur if:

    • You do not have shoes with good support
    • You jump a lot (such as when playing basketball)
    • You run on hard surfaces such as concrete or you run too often
    • You suddenly increase the amount or intensity of an activity
    • Your calf muscles are very tight (not stretched out)
    • Your foot suddenly turns in or out

    Tendonitis can also occur when a bone spur forms at the back of the heel. This can irritate the Achilles Tendon, causing pain and swelling, and is more common among older people.

  • The main symptoms of Achilles Tendonitis are pain and swelling at the back of the heel. You should consult your doctor if you:

    • Are unable to bend the ankle
    • Are unable to walk comfortably on the affected side
    • Experience swelling of the calf
    • Have an injury that causes deformity around the joint
    • Have ankle pain at night or while you are resting
    • Have ankle pain for longer than a few days
    • Experience signs of infection, including fever, redness or warmth
  • Treatment depends on the cause of the problem. You may be treated as follows:

    • Heat pads to relax muscles and stimulate blood flow
    • Ice packs to minimise swelling
    • Non-steroidal anti-inflammatory drugs to treat pain
    • Physiotherapy to increase strength and regain mobility
    • Rest to treat inflammation
    • Steroid injections to treat inflammation
    • Stretching to loosen the calf muscle

    Surgery is usually only offered for recurrent injuries and persistent pain, but may be needed if the tendon tears or there are loose ligaments.

  • Achilles tendinitis may lead to Achilles tendon rupture. This condition usually causes a sharp pain, and surgical repair is necessary.

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