Achilles tendonitis is inflammation of the Achilles tendon. The Achilles tendon is a large, thick tendon that connects the
muscles of the calf to the heel. The inflammation can be caused by overuse, injury, infection or arthritis. This inflammation
will cause pain just above the heel, which will be worse with movement of the heel and may be worse at night. Anti-inflammatories
will relieve pain and inflammation. A period of rest will aid recovery.
Alternative Names
- Achilles tendiniti
- Tendonitis of the heel
What is it?
Achilles tendonitis refers to inflammation of the Achilles tendon. This tendon is a large, thick, fibrous structure that connects the muscles of the calf to the heel.
Causes
Inflammation can be caused by:
- Overuse - straining or exercising excessively
- Injury
- Infection
- Arthritis - inflammation in a nearby joint can extend to the tendon
Achilles tendonitis can also occur when the calf muscles contract repeatedly or with much force – typically this affects runners. Runners are at risk if they have:
- Shortening of the calf muscle
- Lack of flexibility of the calf muscle
- Shoes with inadequate stability or shock absorption
- Sudden inward or outward turning of the heel when hitting the ground
- A habit of running on hard surfaces such as concrete
Diagnosis
Pain will be felt 4-6cm above the bottom edge of the heel. The pain may worsen with movement.
Ultrasound (a test that uses sound waves to visualise the tendon and surrounding tissue on a screen) may be used to assess the extent of the inflammation.
Treatment
- Resting the leg will aid recovery; this is sometimes achieved by using a cast.
- A heel lift may be used to prevent strain on the Achilles tendon.
- The application of heat (heating pad) or cold (ice pack) will reduce the pain and inflammation.
- NSAIDs (non-steroidal anti inflammatories) like ibuprofen (Brufen) will relieve pain, in addition to reducing inflammation (swelling).
- If the injury is caused by overuse, a change in work habits or recreational activities may be needed to prevent recurrence.
Outcome
The symptoms usually improve with treatment and rest, although this often takes quite some time.The complications that may occur are:
- Recurrence
- Calcification of the tendon - the tendon becomes thick and inflexible when calcium deposits develop
After recovery, strengthening and stretching exercises of the surrounding muscle and tendon may prevent recurrence.