What is Achilles Tendinitis?

Achilles tendonitis refers to inflammation of the Achilles tendon. The Achilles tendon is a strong, fibrous cable that connects the calf muscles to the heel bone and runs down the back of the leg. It is used when performing various activities such as walking, climbing, jumping, running, and standing on the toes. The primary function of the Achilles tendon and associated muscles is to slow the progression over the foot when walking. It prevents one from falling forward while walking, especially down an incline or downstairs.

Common Causes of Achilles Tendinitis

Achilles tendonitis is the result of repetitive stress on the Achilles tendon, which can stem from various sources such as sudden escalation of activity, intense physical activity, overuse of the tendon, or degeneration of the tendon. Additionally, other factors that may lead to this condition include tight calf muscles, bone spurs, extra bone growth, infection, and rheumatoid arthritis.

Types of Achilles Tendinitis

Achilles tendinitis can vary in type depending on the location of the affected area of the tendon. Insertional Achilles tendinitis affects the lower part of the tendon where it connects to the heel bone, and can also manifest with a large bone spur. On the other hand, non-insertional Achilles tendinitis impacts the middle part of the tendon, leading to small tears, swelling, and thickening. This type of tendinitis is commonly found in active and young individuals.

Symptoms

Achilles tendinitis is often characterized by stiffness and pain along the Achilles tendon, swelling and thickening of the tendon, as well as discomfort and swelling at the back of the heel. Other warning signs include increased pain in the back of the heel during physical activity, warm skin on the heel, limited motion, and tightness in the calf muscles.

Without proper treatment, Achilles tendinitis can cause severe pain, hindrance in walking or exercising, distortion of the heel bone or tendon, and even a rupture of the Achilles tendon in severe cases.

Diagnosis

To diagnose Achilles tendinitis, a physician will need to perform a thorough examination of your lower leg, including the ankle, foot, heel, and calf, checking for symptoms of the condition and reviewing any possible causes. The doctor may also apply pressure to the affected area to determine the precise location of the injury. Imaging tests may be required to confirm the diagnosis, and various techniques can be used, including MRI, x-ray, and ultrasound. X-rays can detect bone spurs and calcification, while MRI can identify ruptured tendons and tissue degeneration, and ultrasound can detect any damage and inflammation present.

Treatment

The treatment for Achilles tendinitis varies depending on the type and severity of the injury and the patient’s level of comfort. Typically, doctors begin with non-surgical treatments and progress to more invasive options such as surgery if necessary. The RICE protocol, which stands for Rest, Ice, Compression, and Elevation, is commonly recommended for treating Achilles tendinitis, and it often yields positive results.

For more severe cases of tendinitis, physicians may prescribe oral or topical non-steroidal anti-inflammatory drugs (NSAIDs), steroids, or Platelet-rich Plasma (PRP) injections. Additionally, braces and physical therapy can also be used.

If the patient experiences no improvement after six months of non-surgical treatment, surgery is often the next step. The type of surgery recommended is based on the location of the tendinitis and the extent of damage to the tendon.

Surgical Procedure

Many procedures for Achilles tendinitis are performed through an “open” approach, which involves making an incision and opening the leg rather than using minimally invasive techniques. The surgeon then repairs the tendon using the most appropriate method for the type of injury the patient has. In cases where the tendon is severely damaged, a tendon transfer may be necessary. In other cases, only the damaged portion of the tendon needs to be removed, and the healthy portion can be sutured back together. There are several common methods for treating Achilles tendinitis, including debridement and repair, debridement with tendon transfer, and gastrocnemius recession. The choice of surgical procedure depends on the individual circumstances of the patient’s injury.

If you are experiencing the symptoms of Achilles tendinitis, our team at Flint Foot and Ankle is available to provide expert care. Our experienced foot and ankle orthopedic surgery professionals are equipped to address this condition through both nonoperative and surgical approaches. Flint Foot and Ankle takes pride in developing individualized treatment plans tailored to meet the unique needs of each patient. Do not let the pain and discomfort of Achilles tendinitis limits your daily activities – contact us today to schedule a consultation and start your journey toward recovery.