Achilles Tendinitis / Tendinosis

The Achilles tendon connects the muscles of the calf to the calcaneus (heel bone). It allows you to push off during walking, running, or standing on your toes. The tendon consists of many small fibers running in parallel and resembles a thick cable.

Injury to the Achilles tendon can take several forms. Tendinitis is inflammation of the lining of the tendon. This is commonly related to overuse in an active individual. Tendinitis may begin with a small injury to the tendon that is then not allowed to heal before re-injury occurs. Achilles tendinosis is degeneration from wear-and-tear. The tendon becomes thickened and swollen. The tendon remains intact overall, but some fibers are no longer doing their job. Think of tendinosis as a chronic tear of some of the fibers within the cable. Both Achilles tendinitis and tendinosis can occur at the mid-substance of the tendon or at the tendon’s insertion at the calcaneus.

Treatment of both Achilles tendinitis and tendinosis typically begins with activity modification in order to allow the tendon to rest. This may involve a simple change in activity or at times immobilization in a brace or cast. Depending on the specifics of the injury, further treatments may involve physical therapy, continued bracing, ultrasound, or surgery. At times, a “night splint” (we can prescribe this) can be very helpful in keeping the Achilles tendon stretched while you are sleeping. A heel lift placed in your shoe can also help to relieve pressure on the tendon when walking or exercising.

You should avoid steroid injections around the tendon, as this can weaken the tendon and lead to full rupture. Certain antibiotics, such as the fluoroquinolone family of medications, may cause weakening of the tendon and contribute to tendon rupture.

Listed below is a stretching exercise that has been shown to help with Achilles pain.

Achilles Tendon Stretch
achilles-tendon-stretch
  1. Stand facing a wall. Press your palms on the wall and bend the unaffected leg until your knee is directly over your toes. The leg affected by the Achilles pain should remain straight.
  2. Slowly move the straight leg backward until you feel a stretch in your calf. Hold the stretch for 30 seconds.
  3. Repeat the exercise for the other leg if both sides are injured.

Number of stretches per set: 3 – 5 (30 seconds each)
Sets per day: 3 – 5

 

 

 

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