Achilles Tendinitis

Overview

Achilles tendinitis is an injury that affects the Achilles tendon, the strong band of tissue that connects the calf muscles at the back of the lower leg to the heel bone. This condition often develops due to overuse, such as putting repeated or excessive stress on the tendon without enough time to rest. In some cases, Achilles tendinitis may occur without a clear cause.

The condition is also referred to as Achilles tendinopathy, a general term used to describe disorders of the tendon. It is commonly seen in runners who suddenly increase the intensity, distance, or duration of their training. Middle-aged adults who participate in sports like tennis or basketball only occasionally, such as on weekends, are also at higher risk.

Most cases of Achilles tendinitis can be managed with at-home care under the guidance of a healthcare professional. These measures often help relieve symptoms and reduce the chance of the condition returning. However, severe or untreated cases may weaken the tendon and lead to tears, known as ruptures, which may require surgical repair.

Symptoms

Pain from Achilles tendinitis often starts gradually and may be mild at first. It usually appears in the back of the leg or just above the heel, especially after running or other physical activities.

Common symptoms include:

• A dull ache or pain after exercise

• Burning or aching pain that worsens after prolonged activity, stair climbing, or sprinting

• Pain that may eventually occur even during rest

• Stiffness and tenderness along the tendon, especially in the morning

• Difficulty using the affected foot

• Soreness that often improves with mild activity

As the condition progresses, symptoms may become more persistent and interfere with daily activities and physical performance.

Causes

Achilles tendinitis is most often caused by repeated or intense strain on the Achilles tendon. This strain places stress on the tendon fibers, leading to irritation and inflammation. In some cases, the exact cause may not be clear.

The injury can occur in the middle portion of the tendon or at the point where the tendon attaches to the heel bone. Aging also plays a role, as the Achilles tendon naturally becomes less flexible and weaker over time, making it more prone to injury.

People who suddenly increase their level of physical activity, such as running longer distances or at a faster pace without proper conditioning, are especially vulnerable to developing Achilles tendinitis.

Risk factors

Several factors can increase the likelihood of developing Achilles tendinitis:

• Increasing age, as tendon flexibility decreases over time

• Foot structure issues, such as flat feet or high arches, which place extra stress on the tendon

• Obesity or tight calf muscles that increase strain on the Achilles tendon

• Differences in leg length

• A previous history of Achilles tendinitis

• Wearing worn-out shoes or shoes with poor support

• Poor running technique or sudden changes in training intensity

• Participating in physical activity during cold weather

• Running uphill frequently

• Medical conditions such as psoriasis, high cholesterol, or high blood pressure

• Use of certain antibiotics, particularly fluoroquinolones

Complications

If not properly managed, Achilles tendinitis can weaken the tendon over time. This weakening increases the risk of a tendon tear, also known as an Achilles rupture. A rupture is a serious injury that often requires surgical treatment and a lengthy recovery period.

Prompt treatment and appropriate self-care are important to prevent long-term damage and reduce the risk of complications.