The Achilles Tendon is also known as the heel cord. It is one of the largest and strongest tendons in the human body. It connects the lower leg muscles to the foot through an attachment on the heel bone in the back of the foot. The Achilles tendon allows us to rise up on our toes and allows us to walk. When this tendon becomes inflamed, it is called tendonitis.
Achilles tendonitis is a painful condition where the heel cord becomes swollen and inflamed. Achilles tendonitis can be caused by a single strain to the Achilles tendon or by repeated stresses to the tendon. The condition often occurs in athletes secondary to overuse of the Achilles tendon but also occurs when people start an exercise program or increase activity and do not have the tendon strength or flexibility to perform the activity. Increased pronation can cause the foot to flatten and predispose a person to Achilles tendonitis. This position causes the muscles and tendons of the lower leg to stretch more than is normal. Also, when women wear high heels a lot, the calf muscles adapt to that shortened position. When she switches to tennis shoes or lower heels, the Achilles tendon is stretched beyond its flexible limit and can strain.
Achilles tendonitis typically develops slowly and gradually worsens. It usually starts with very mild pain that may increase with activity. The pain can gradually worsen, and the tendon may tear if it continues to be overstressed. If the tendon does rupture, the patient will be unable to walk normally. The treatment for a ruptured tendon is surgery. Diagnosis of Achilles tendonitis is based on swelling of the tendon, tenderness, and thorough history taking into account the changes in activity levels and footwear. Treatment of Achilles tendonitis depends on the severity of the condition. Activity levels should be modified avoiding the causative activity. Non-steroidal anti-inflammatories will help to reduce inflammation of the tendon. Proper stretching and strengthening exercises can be done to improve flexibility and strength of the tendon. Orthotics can be used to help the alignment of the foot and decrease stress to the tendon. If the injury is more severe, a flexible cast may be indicated and the patient may be placed on crutches. In extreme cases, surgery may be indicated to allow the tendon to heal. This is followed by several weeks of physical therapy to restore motion and function.
Prevention of Achilles tendonitis begins with proper footwear and proper conditioning to maximize flexibility and strength of the Achilles tendon. Warming up prior to participation in vigorous activity is helpful as a preventative measure. If pain does begin in the heel cord, then activity should be stopped and ice applied to prevent the condition from progressing to a more severe form.
If you have pain in your heel or ankle, you should consult a qualified health care provider for evaluation and proper treatment.