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Achilles Tendonitis (Heel Pain & Injury)

  • What is achilles tendonitis?

    The Achilles tendon is in the back of the ankle, connecting the calf muscles to the heel bone. This tendon is needed for walking, running and jumping. It withstands a great deal of stress during normal daily life. Achilles tendonitis occurs when the muscles and tendon are overused, causing irritation to and swelling of the tendon.

    There are 2 types of Achilles tendonitis:

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

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

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

    • Do not have shoes with good support
    • Jump a lot (eg. playing basketball)
    • Run on hard surfaces (eg. concrete) or you run too often
    • Suddenly increase the amount or intensity of an activity
    • Have tight calf muscles (not stretched out)
    • Observe your foot suddenly turning in or out

    Tendonitis can also occur when a bone spur (bony growth) forms at the back of the heel, irritating the Achilles tendon to cause pain and swelling. This tends to be 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:

    • Cannot bend your ankle
    • Cannot walk comfortably on the affected side
    • Experience swelling in your calf
    • Have an injury that causes deformity around the joint
    • Have ankle pain at night or while at rest
    • Have ankle pain for more than a few days
    • Experience signs of infection, including fever, redness or warmth
  • Treatment depends on the cause of the problem. Some treatments include:

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

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

  • Achilles tendonitis may lead to Achilles tendon rupture, which is a partial or complete tear of the tendon. This condition usually causes a severe and sharp pain, requiring surgical repair for treatment.

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