Feet
> Achilles Tendinitis
What is the Achilles Tendon?
The Achilles tendon is a fibrous band of tissue that
connects your calf muscles to your heel bone (calcaneus).
It allows you to lift your heel off the ground.
Most commonly an overuse injury, Achilles tendinitis
is inflammation in any portion of the Achilles tendon,
and can range in severity from mild swelling to a complete
rupture. Achilles tendinitis can happen at the same
time as plantar fasciitis, causing foot pain in the
heel and ankle. Achilles tendinitis also can be associated
with other foot problems, such as painful flat feet.av=PAT&doc_id=29"
target="_new">William G. Hamilton, M.D.,
team physician for the New York Knicks and New Jersey
Nets.
Achilles tendinitis
is typically caused by unusual use or overuse of the
lower leg muscles and Achilles tendon. Tightness in
the Achilles is the main predisposing factor to strains
and tendinitis. Repetitive jumping, kicking, and sprinting
can cause Achilles tendinitis in both recreational and
competitive athletes. Runners, dancers, and athletes
over age 65 are especially at risk. Sudden increases
in training or competition can also inflame your Achilles
tendon. For example, adding hills, stair climbing, or
sprinting to your running workout puts extra stress
on your Achilles tendon. Improper technique during training
can also strain the tendon. Intense running or jumping
without stretching and strengthening your lower leg
muscles can put you at risk regardless of your age or
fitness level. Running on tight, exhausted, or fatigued
calf muscles put added stress on your Achilles tendon.
Your tendon may not be ready to quickly start a new
workout after periods of inactivity. Direct blows or
other injuries to the ankle, foot, or lower leg may
pull your Achilles tendon too far and stretch the tissue.
A hard contraction of the calf muscles, like pushing
for the final sprint in a race, can strain the tendon.
People whose feet roll inward, called overpronation,
are particularly at risk. Shoes with stiff soles in
the ball of the foot, where the toes join the foot,
or too much heel cushioning put extra strain on the
Achilles tendon when running or walking.av=PAT&doc_id=29"
target="_new">William G. Hamilton, M.D.,
team physician for the New York Knicks and New Jersey
Nets.
Most cases of
Achilles tendinitis can be treated in about six weeks
without surgery, though you may be able to recover faster
from tendinitis caused by a direct blow than you can
from an overuse injury. Surgery is only considered if
your Achilles tendinitis has not healed after six to
12 months of non-surgical treatment. It is important
to visit your physician to rule out other foot problems.
Several conditions like plantar fasciitis, stress fractures,
and arthritis may be contributing to your foot pain.
If left untreated, Achilles tendinitis usually worsens
into a chronically painful condition that increases
the risk of tendon rupture. Many people mistakenly believe
they can play through the pain, but tendinitis can become
a serious injury if not treated properly. Resuming activities
too soon may increase your healing time and put you
at risk for repeated tendon injuries.av=PAT&doc_id=29"
target="_new">William G. Hamilton, M.D.,
team physician for the New York Knicks and New Jersey
Nets.
Orthopedic Evaluation
There are usually three
parts to an orthopedic evaluation: medical history,
a physical examination, and tests that your doctor may
order.
Your physician
likely will ask about your activities, which may have
caused the tendinitis. You may be asked when the soreness
or pain began. If you have had any prior Achilles tendon
injuries, your physician will ask about the treatments
you have tried in the past. You may be asked how long
your Achilles tendon took to begin swelling, and whether
you were able to continue playing after you noticed
the pain. Physicians also typically ask about other
conditions, such as diabetes and allergies, and medications
currently being taken. You also may be asked about your
physical and athletic goals – information that
will help decide what treatment might be best for you
in achieving those goals.
Physicians usually
pinch your Achilles tendon with their fingers to test
for swelling and pain. You will probably be asked to
walk around the exam room so your physician can examine
your stride. To check for complete rupture of the tendon,
your physician may perform the Thompson test. Your physician
squeezes your calf; if your Achilles is not torn, the
foot will point downward. If your Achilles is torn,
the foot will remain in the same position.
Should your
physician require a closer look, these imaging tests
may be conducted:
X-rays
taken from different angles may be used to rule out
other problems like ankle fractures.
MRI
(magnetic resonance imaging) uses magnetic waves to
create pictures of your ankle that let physicians more
clearly look at your tendons.
Imaging
techniques
av=PAT&doc_id=29" target="_new">William
G. Hamilton, M.D., team physician for the New York Knicks
and New Jersey Nets.
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