Achilles tendonitis
Fast facts
- Achilles tendonitis is the result of damage to the Achilles tendon.
- It is typically a result of tendon overuse or sudden force through the tendon
- It is commonly experienced by athletes. It may also occur in walkers or young people who are physically active.
What is Achilles tendonitis?
Achilles tendonitis happens when the Achilles tendon becomes inflamed.
Cause
Tendons are a type of connective tissue that connect muscle to bone. The Achilles tendon (also known as the calcaneal tendon) connects the calf muscle to the heel bone. It is one of the largest and strongest tendons in the body.
The Achilles tendon enables the heel to lift when we walk, run or jump. Despite its strength, strains, tears or ruptures are common, particularly when we make fast, sudden movements such as sprinting, stumbling or falling.
Inflammation and tearing of the Achilles tendon in Achilles tendonitis.
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Connective tissue
A category of body tissue that connects and supports other body tissues.
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
Risk factors
Risk factors for Achilles tendonitis include:
- Physical stress on the Achilles tendon, resulting in injury;
- Arthritis - tendon structure can be affected by inflammatory types of arthritis, such as rheumatoid arthritis;
- Shoes that do not provide good support, such as high heels;
- Foot problems such as flat arches or feet that turn inward while walking;
- Obesity - being overweight or obese puts strain on the Achilles tendon, and;
- Quinolone antibiotics - these antibiotics have been associated with tendon inflammation.
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
Types
There are three types of Achilles tendonitis:
- Mild - in which pain is felt during a particular physical activity or shortly after it;
- Moderate - the tendon is swollen. In some cases a hard lump can be felt, or;
- Severe - in which any kind of weight-bearing activity causes pain, or the Achilles tendon may be ruptured. A ruptured tendon will usually be felt as a snap or a pop, accompanied by a sharp pain in the heel and ankle area.
Signs and symptoms
Signs and symptoms of Achilles tendonitis include:
- Pain in the rear of the heel;
- Difficulty and pain during walking, and;
- Swelling, tenderness or inflammation of the heel and the surrounding area.
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
Methods for diagnosis
Achilles tendonitis can be diagnosed by a physical examination. Other tests, such as an X-ray, ultrasound or magnetic resonance imaging (MRI) may be recommended to confirm the diagnosis. An MRI is typically used in cases of a torn Achilles tendon, or when surgery may be required.
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MRI
A type of imaging that uses a magnetic field and low-energy radio waves, instead of X-rays, to obtain images of organs.
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X-ray
A scan that uses ionizing radiation beams to create an image of the body’s internal structures.
Types of treatment
Reducing strain
Treatments for Achilles tendonitis are aimed at reducing the strain on the affected tendon to promote healing. This can be done by:
- Avoiding strenuous physical activities, or;
- Wearing footwear inserts, called orthoses. These are made by a podiatrist.
Reducing inflammation
Inflammation can be reduced by:
- Using icepacks on the heel, and;
- Taking non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections.
Your doctor can also suggest exercises to stretch and strengthen the muscles in the surrounding area once the inflammation has settled.
Surgery
If the tendon has ruptured, surgery may be needed to reconnect the torn ends of the tendon.
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Inflammation
A body’s protective immune response to injury or infection. The accumulation of fluid, cells and proteins at the site of an infection or physical injury, resulting in swelling, heat, redness, pain and loss of function.
Potential complications
The main complication of Achilles tendonitis is the weakening of the Achilles tendon, increasing the risk of more serious rupture in the future.
Prognosis
With treatment, Achilles tendonitis that is not severe will generally heal within a few months.
A more severe case of Achilles tendonitis will require more time and supportive physiotherapy to recover completely.
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Physiotherapy
A healthcare profession that treats bodily weaknesses or defects with physical remedies, such as massage or exercise.
Prevention
You can prevent Achilles tendonitis by:
- Maintaining a healthy weight;
- Taking care when wearing high heels;
- Wearing supportive shoe inserts;
- Avoiding strenuous exercises if you feel pain or discomfort in the Achilles tendon, and;
- Performing gentle stretching exercises before and after sport or general exercise.
5 Most frequently asked questions (FAQs)
What is Achilles tendonitis? Achilles tendonitis is inflammation of the Achilles tendon (also known as the calcaneal tendon) as the tendon is strained, torn or ruptured. It is typically a result of tendon overuse or sudden force through the tendon and is commonly experienced by athletes. It may also occur in walkers or young people who are physically active. What are the symptoms of Achilles tendonitis? Signs and symptoms of Achilles tendonitis include: • Pain in the back of the heel; • Difficulty and pain during walking, and; • Swelling, tenderness or inflammation of the heel and the surrounding area. What causes Achilles tendonitis? Causes of Achilles tendonitis can include: • Stress on the Achilles tendon, resulting in injury such as tearing or stretching of the tendon; • Arthritis - tendon structure can be affected by inflammatory types of arthritis, such as rheumatoid arthritis; • Footwear and foot problems - shoes that do not provide good support, such as high heels, and foot problems such as flat arches, increase the risk of developing Achilles tendonitis; • Obesity - being overweight or obese puts strain on the Achilles tendon, and; • Quinolone antibiotics - these antibiotics have been associated with inflammation of tendons. How is Achilles tendonitis diagnosed? Achilles tendonitis can be diagnosed by a physical examination. Other tests, such as an X-ray, ultrasound or magnetic resonance imaging (MRI) may be recommended to confirm the diagnosis. An MRI is typically used in cases of a torn Achilles tendon, or when surgery may be required. How is Achilles tendonitis treated? Treatments for Achilles tendonitis are aimed at reducing the strain on the tendon to promote healing. This can be done by avoiding strenuous physical activities or obtaining footwear inserts, called orthoses, from a podiatrist. Inflammation can be reduced by using icepacks, non-steroidal anti-inflammatory drugs (NSAIDs) or corticosteroid injections. The doctor may also provide specific exercises to stretch and strengthen the muscles in the surrounding area once the inflammation has settled. Surgery may be necessary in a case of a ruptured Achilles tendon to reconnect the torn ends of the tendon.
Related topics
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Ligaments are bands of strong, flexible tissue that connect bones or cartilage, providing stability to joints. Knee ligament injuries can occur when your knee is hit forcefully, you land on it badly, or it sharply changes direction. Symptoms include swelling and pain, reduced movement, a popping sound, a feeling of instability and sometimes bruising.