Achilles Tendonitis (Tendinitis) is a common injury in runners and other athletes who play sports that requires lots of running mileage, particularly stop and starts run often during sports. The repetitive stress of running, and the increased tension on the tendon can lead to inflammation and pain over time.
What Is the Achilles Tendon?
The Achilles tendon is the largest and most vulnerable tendon in the body.
It joins the gastrocnemius (calf) and the soleus muscles of the lower leg to the heel of the foot. The gastrocnemius muscle crosses the knee, the ankle, and the subtalar joints and can create stress and tension in the Achilles' tendon. Tendons are very strong, but not very flexible so they can only stretch so far before they become inflamed and tear or even rupture (a complete tear).
Achilles tendonitis can come on gradually or suddenly. Acute symptoms are hard to ignore, and includes pain in the back of the ankle and just above the heel that comes on quickly over a few days. It increases during exercise (particularly running). It often has a very specific pinpoint tenderness or soreness that increases when palpated.
Chronic Achilles tendonitis often results from a bout of acute tendonitis that fails to heal properly. It's important to always let soft tissue injuries heal completely before returning to high-level sports.
Athletes who return too soon or do too much risk turning a short-term injury into a long-term injury.
In some cases, tendonitis comes on slowly and gradually gets worse over weeks or months. This type of pain is often worse in the morning upon waking and eases as you warm up and stretch the tendon.
A chronic condition may actually cause small scar-like bumps to develop in the tendon. If you run your hand over the Achilles you may feel small lumps and bumps.
Achilles tendonitis is a chronic injury that occurs primarily from overuse. It tends to come on gradually over time until the pain is constant and exercise or activity too painful to continue. The biggest cause of chronic Achilles tendonitis is ignoring early warning signs and pushing through the pain. If the Achilles' tendon is sore or aches, you need to pay attention and rest it immediately.
Another major contributor to the development of Achilles tendonitis is a lack of flexibility in the calf muscles, which cause the muscle to shorten which creates more tension in the tendon. Overuse can also contribute to Achilles tendonitis as can a sudden increase in training mileage, hill running or a lot of speedwork. The Achilles' tendon has a limited blood supply, which makes this injury slow to heal. Early recognition of any tension, aches or tenderness is the most important aspect of treating tendon injuries.
At the first sign of Achilles tendon pain, cut back and reduce your training. Stop speed training and hill running, and begin gentle calf stretching after exercise when the muscle and tendon are still warm and flexible.
Post-exercise ice may also help. Be careful to avoid excessive stretching that could aggravate the problem. Strengthening the calf muscle can help reduce the stress on the Achilles' tendon. Toe raises, and balancing on your toes, and wall stretching are useful exercises.
It is not necessary to stop activity completely (you may consider cross training) as long as you pay attention to muscle soreness and reduce activity accordingly.
Some experts believe that eccentric strengthening of the Achilles, gastrocnemius, and soleus muscles may reduce the risk of Achilles tendonitis and calf strain