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Achilles Tendinitis

The Makovicka Difference

We are leaders in our profession, locally owned and operated by physical therapists who forge relationships with patients, and advocate for their care. All of our clinics have board-certified specialists on staff, meaning you get the highest level of care to maximize your recovery, and get you back to your game. We will listen, evaluate your symptoms, and create a personalized physical therapy program to meet your needs and improve your function, strength, and mobility.

Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury. The condition occurs most commonly in runners who increase the intensity or duration of their normal runs too rapidly. In addition, it occurs in individuals who are “weekend warriors”, playing sports such as tennis or basketball only on the weekends.

Most cases of Achilles tendinitis can be treated with exercises under your doctor’s and physical therapist’s supervision. Self-care strategies are usually necessary to prevent recurring episodes. More serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activities. Episodes of more-severe pain may occur after prolonged running, stair climbing or sprinting. You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity.

Achilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes.

A number of factors may increase your risk of Achilles tendinitis, including:

  • Your sex.  Most common in men.
  • Age.  More common as you age.
  • Physical problems. A naturally flat arch in your foot can put more strain on the Achilles tendon. Obesity and tight calf muscles also can increase tendon strain.
  • Training choices. Running in worn-out shoes can increase your risk of Achilles tendinitis. Tendon pain occurs more frequently in cold weather than in warm weather, and running on hilly terrain also can predispose you to Achilles injury.
  • Medical conditions. People who have psoriasis or high blood pressure are at higher risk of developing Achilles tendinitis.
  • Medications. Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.

Reducing Your Risk:

While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk:

  • Increase your activity level gradually.  If you’re just beginning an exercise regimen, start slowly and gradually increase the duration and intensity of the training.
  • Take it easy.  Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest.
  • Choose your shoes carefully.  The shoes you wear while exercising should provide adequate cushioning for your heel and should have a firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good condition but don’t support your feet, try arch supports in both shoes.
  • Stretch daily.  Your physical therapist can teach you stretches for your calf muscles and Achilles tendon, to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis.
  • Strengthen your calf muscles.  Strong calf muscles enable the calf and Achilles tendon to better handle the stresses they encounter with activity and exercise. A physical therapist has the knowledge to supply you with the appropriate strengthening exercises.
  • Cross-train.  Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and swimming.

Betsy Anderson PT, MSPT

Source:  Mayo Clinic: Patient Care and Health Information, Diseases & Conditions