Achilles tendinitis is a common but often debilitating condition that affects the achilles tendon (the thick band of tissue connecting your calf muscles to your heel bone). This tendon plays a crucial role in walking, running, and various lower limb movements. When inflamed or irritated, it can result in persistent pain and hinder daily activities. Understanding the causes, symptoms and effective treatment methods for achilles tendinitis is vital for managing and alleviating this condition.
What is Achilles Tendinitis and What Does it Feel like?
Achilles tendinitis commonly refers to the inflammation of the Achilles tendon, typically caused by overuse or repetitive stress on the tendon. The condition can range from mild discomfort to severe pain, impacting the ability to walk or engage in physical activities.
Symptoms of Achilles tendonitis:
- Pain and stiffness along the achilles tendon – Usually felt as a mild ache in the back of the heel upward towards the calf muscles.
- Tenderness or swelling – The affected area may be tender to touch and visible swelling might occur around the tendon.
- Difficulty in movement – Stiffness or limited flexibility making it challenging to push off your toes when walking or running.
- Weakness-because of pain or stiffness the ankle, calves, walking, running, or similar motions can feel not as strong as they should be.
What Causes Achilles Tendonitis?
Several factors contribute to the development of Achilles tendonitis
- Overuse or repetitive stress – Engaging in activities that require repetitive movements such as running and jumping. Or, sudden increases in intensity or duration of physical exercise, can strain or load the Achilles tendon too much over a short period of time resulting in an overuse injury such as achilles tendonitis.
- Tight calf muscles – Reduced flexibility in the calf muscles can increase strain on the achilles tendon during movement.
- Improper footwear – Wearing shoes with inadequate support or high heels that place excessive stress and strain on the tendon can contribute to its irritation and inflammation.
- Poor technique / improper training for the specific action you want to perform. For example, swimming is not a great way to train for a marathon. Swimming may be an endurance exercise and a great way to cross train. However if you only swam for aerobic exercise and went to run a marathon you will likely develop an overuse injury simply because of the poor choice in training method for the intended goal.
Other things that can make you more likely to develop Achilles tendinopathy include:
- Previous injury history
- Having certain long-term health conditions such as Rheumatoid arthritis, diabetes, high cholesterol or thyroid conditions.
- Being overweight or obese
- Certain medications – Corticosteroid use, Antibiotics belonging to the quinolone group, or statins.
How to Fix Achilles Tendonitis
Managing and alleviating achilles tendonitis involves a combination of conservative treatments and lifestyle adjustments. Here are effective methods to help address the condition.
Making lifestyle adjustments.
These do not need to be permanent, but short term changes can help to reduce the pain. The most important lifestyle adjustment is finding what is the most provocative activity that flares up your achilles tendon and reducing 1 or more of the following categories:
- Frequency of training – How often you train or perform the provocative action per week
- Intensity / speed – How fast you or how heavy you perform each rep of your activity. Jogging v sprinting for example.
- Duration – How long you perform the provocative action for.
Heavy and slow loading
Once you’ve made these lifestyle adjustments above, use the time you have now to load your achilles tendon appropriately. Slow or even isometric (static holds) loading is a great way to start your rehab journey progressively working towards faster movements. The devil is in the details here. If this is done too aggressively it can flare up your achilles. Done not intensely enough and it won’t make a difference. Finding the right entry point is key to your success.
Progressive return to activity
Starting from slow and heavy training to progressively quicker loading ultimately getting back to jumping and then running to tolerance. Once that is painfree you may be able to return back to jumping and running without pain. Then increase the aforementioned categories of frequency, intensity, and duration so that you can get back to doing what you want to do without compensations or limitations.
Pain management techniques
Massage, dry needling, gentle stretching, kinesiotaping, and many other techniques all can help with your symptoms as your achilles tendonitis pain is dominating your movements and as you progress through your rehab process. Ice can help with pain however, it has been shown to potentially delay healing times. It’s important to recognize that with pain there is a victim and culprit scenario. So while we have to reduce the pain we also have to eliminate the cause of the pain. Just reducing the pain will get it to go away. But it will come back again if the cause of the pain is not addressed.
Achilles tendonitis can significantly impact your daily life and physical activities. Not being able to do what you want to do can be extremely frustrating. Not only that it’s very hard to sift through the tons of information on the internet and from your friends/colleagues on what will and won’t work for achilles tendonitis. This frustration leads many people to just give up and avoid the aggravating activities, many of which are passions of theirs. However, with proper care, most cases can be effectively managed and resolved completely. It’s crucial to address symptoms early, follow a structured treatment plan, and make necessary lifestyle adjustments to prevent recurrence and promote healing. If you have had your pain for quite a while, just because you haven’t found anything that has permanently helped, it doesn’t mean there is nothing that can help.
If the pain persists or worsens despite conservative treatments, seeking guidance from healthcare professionals and orthopedic specialists such as our elite team of physical therapists is advisable. Having a physical therapist that is familiar with achilles tendonitis and similar issues and is a specialist in helping people get back to your goals (running, jumping, etc..) is crucial for a timely return to your activities. Understanding the causes, recognizing the symptoms and implementing appropriate treatment methods can significantly aid in easing Achilles tendinitis and restoring mobility, enabling individuals to resume their regular activities with reduced discomfort and improved overall well being.