The Achilles tendon is the largest tendon in the body. It attaches the calf muscles to the heel bone and is very important because it lets you lift your heel when you start to walk. It also helps you to walk, run or stand on tiptoe.

Symptoms of Achilles tendonosis/tendonitis include:

  • Pain in the back of the heel
  • Difficulty walking – sometimes the pain makes walking impossible
  • Swelling, tenderness and warmth of the Achilles tendon.AdobeStock_65799806-WEB

There are several factors that can contribute to Achilles Tendonosis, the most common being overuse of the muscle/tendon following initial injury to the Achilles tendon. A poorly functioning foot can cause the heel to shift outwards and “bow” the Achilles tendon. This damages the tendon sheath, resulting in painful inflammation of the area. A sudden increase in training, excessive hill running and speed work can also lead to inflammation of the Achilles tendon. Excessive heel cushioning and air-filled shoes can, over a period of time, lose their stability if damaged or worn incorrectly. This can cause the heel to sink into the shoe, while the shoe is absorbing shock. This further stretches the Achilles tendon at a time when the leg and body are moving forward over the foot, thereby increasing strain. Tight calf and hamstring muscles may contribute to prolonged Achilles Tendonosis due to the continual “pulling” strain they exert on the tendon.

How Is Achilles Tendon Injury Treated?

Achilles tendonitis is a condition that responds well to conservative treatment if treated early. If disregarded, symptoms and treatment can last for several months. Conservative treatment may include:

  • Training modification. Your training schedule should be reduced to enable healing of the damaged area. This helps to allow successful and effective treatment administration.
  • Rest with your leg elevated above the level of the heart whenever possible in the first 72 hours after injury.
  • Ice or cold compression should be used in the first three days. DO NOT use heat or massage in the first 72 hours as this can make things worse.
  • Compression is necessary in the early stages of treatment to help fight the inflammation.
  • Heel Raises. These help decrease the strain and load on the Achilles tendon.
  • Correction of abnormal body mechanics. Orthotic devices are designed to allow the foot to function around its normal position, allowing the Achilles to recover and prevent recurrence of the injury.
  • Stretching and physical therapy. Mild stretching, massage and strengthening exercises are prescribed to restore the extensibility of the tendon, increase strength and hasten full recovery.
  • Anti-inflammatory medication. Please ask your pharmacist about this. This may also be required during the initial treatment.

It can take several weeks or even months for the tendon to heal depending upon the severity of the injury to the tendon. It is not uncommon for a patient to return to activities too quickly and re-injure the tendon. Careful monitoring of a return to full activity is important and the patient must have patience during this period of time.