The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. It also is the most frequently ruptured tendon, usually as a result of a sports injury. Both professional and weekend athletes may suffer from Achilles tendonitis, a common overuse injury and inflammation of the tendon.
Events that can cause Achilles tendonitis may include:
- Hill running or stair climbing.
- Overuse, stemming from the natural lack of flexibility in the calf muscles.
- Rapidly increasing mileage or speed when walking, jogging, or running.
- Starting up too quickly after a layoff in exercise or sports activity, without adequately stretching and warming up the foot.
- Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort, such as in a sprint.
- Improper footwear and/or a tendency toward overpronation.
- Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include:
- Recurring localized pain, sometimes severe, along the tendon during or a few hours after running.
- Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone.
- Sluggishness in your leg.
- Mild or severe swelling.
- Stiffness that generally diminishes as the tendon warms up with use.
This is a condition that requires the patient to take an active role in treatment. Treatment normally includes:
- Heel raise in the shoe or a shoe with a heel (1 to 1 1/2 inches) can reduce tension.
- A bandage specifically designed to restrict motion of the tendon.
- Taking nonsteroidal anti-inflammatory medication for a period of time. Note: Please consult your physician before taking any medication.
- Rest and switching to exercises that do not stress the tendon (such as swimming).
- Apply ice four or five times a day for 20 to 30 minutes.
- Orthotics, which are corrective shoe inserts designed to help support the muscle and relieve stress on the tendon. Both nonprescription orthoses (such as a heel pads or over-the-counter shoe inserts) and prescribed custom orthotics may be recommended depending on the length and severity of the problem.
- Stretching and exercises to strengthen the weak muscle group in front of the leg, calf, and the upward foot flexors, as well as massage and ultrasound.
- In extreme cases, surgery is performed to remove the fibrous tissue and repair any tears.
Exercise is only safe when the heel is no longer swollen or tender. If pain increases with exercise, however, the person should stop immediately. If pain continues, the tendon can rupture.