Achilles tendonitis is a specific type of tendonitis that occurs in the Achilles tendon at the back of the heel. The Achilles tendon is a thick rope-like piece of connective tissue that connects the heel bone to the calf muscles at the back of the lower leg.
Achilles tendonitis is primarily an overuse injury, particularly among those who suddenly increase the intensity or duration of their activities that places strain on the tendon can result in this chronic inflammatory condition. Other factors that affect the likelihood of developing Achilles tendonitis are exercising without a sufficient warmup, playing sports with quick stops and changes in direction, suddenly increasing the amount or intensity of your physical activity, wearing ill-fitting shoes without proper support, existing heel spurs that rub on the tendon, and age, since our tendons become less flexible as we get older. Sometimes your back actually plays a role here as well if there is disturbance in the signal controlling the resting length of your calf muscles which places a continual stress on the tendon and eventually causes the tendon to start breaking down due to alterations in how it gets its nutrition.
Similar to other types of tendonitis, repetitive stress on the Achilles tendon causes irritation, inflammation, and sometimes micro-tears in the tendon. Symptoms of Achilles tendonitis are pain and swelling in the back of your heel, tight calf muscles, and limited range of motion when flexing your foot. You may have difficulty getting out of bed in the morning or standing after you have been sitting for a while. Running and going up and down stairs are often difficult and painful activities to perform and it is often tough just to walk. As with other types of tendonitis, early recognition of Achilles tendonitis is important since rest and modifying your activities can help the tendon recover without more serious intervention.
You can help prevent Achilles tendonitis by engaging in a proper warm-up before exercise, combining high- and low-impact activities into your exercise routine, wearing proper shoes with adequate support, and easing into new exercise routines or increasing the intensity of your current routines gradually. Stretching your calf muscles is particularly important in preventing Achilles tendonitis since the tighter your calf muscles are, the more stress and tension that is placed on the Achilles tendon.
The Achilles tendon is also prone to rupturing. This often is a very spontaneous thing that occurs particularly during an activity that involves stopping and starting or when a quick stretch happens at the ankle during weight bearing. Often people feel like they have been kicked and turn around to see who did this and there is no one there…
What can physiotherapy do?
The first step in treating Achilles tendonitis is to remove the overstress situation by addressing abnormal muscle length, poor foot mechanics or support, and activity modification.
Treatment is aimed at resolving the chronic inflammatory response using local modalities such as:
Aquatic exercise or other reduced weight-bearing activities to keep you moving while you recover.
Assessing your footwear
When the area is responding well, we will direct you to exercises that are aimed at improving your foot and lower extremity alignment, balance and stability, and flexibility as well as the strength of the tendon itself in order to remove the overstress situation from the Achilles tendon for the long term and help your body recover from activity as it should.