(Achilles Tendonitis; Achilles Tendinosis)
The Achilles tendon connects the calf muscle at the heel bone. Achilles tendinopathy is pain in this tendon. Treatment can help.
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The exact cause of achilles tendinopathy is not known. It is thought to be from overuse from:
- Increasing speed or running long distances too quickly
- Suddenly adding hills or stair climbing to an exercise routine
- Stressing the calf muscles too soon after taking time away from exercising
- Putting sudden stress on the calf muscles when they are not ready for stress
Achilles tendinopathy is more common in men and older adults. Other things that may raise the risk are:
- Certain lower leg problems, such as lack of flexibility, poor range of motion, or a foot that turns inward too much
- Certain health problems, such as obesity and diabetes
- A poor training program, such as activity on hard surfaces or hills
- Wearing poor footwear
- Certain medicines, such as corticosteroids
Symptoms of achilles tendinopathy may include:
- Pain and stiffness above the heel bone
- Problems that happen when bearing weight after rest, such as after sleeping
- Swelling at the tendon
- Problems wearing shoes
- Decreased strength in the tendon
The doctor will ask about symptoms and past health. The person will be asked about the activities they do. A physical exam will be done. It will focus on the lower leg. This is often enough to diagnose achilles tendinopathy.
If the diagnosis is unclear, images may be taken. This can be done with:
Treatment depends on the tendon and how badly it is damaged. Options are:
- Supportive care with rest and ice
- Ankle taping to support the tendon
- Shoe inserts
- Medicines to ease pain and swelling
- Physical therapy
- Extracorporeal shockwave therapy (ESWT) to stimulate healing
Some people may need surgery when other methods do not help.
Achilles tendinopathy may be prevented by:
- Wearing proper footwear
- Slowly increasing activities
- Stretching and strengthening the calf muscles
- Achilles tendinitis. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/achilles-tendinitis.
- Achilles tendinopathy. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/achilles-tendinopathy
- Achilles tendon disorders. Foot Health Facts—American College of Foot and Ankle Surgeons website. Available at: https://www.foothealthfacts.org/conditions/achilles-tendon-disorders.
- Aicale R, Oliviero A, et al. Management of Achilles and patellar tendinopathy: what we know, what we can do. J Foot Ankle Res. 2020;13(1):59.
- Laura Lei-Rivera, PT, DPT
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