Achilles Tendonitis

Achilles tendinitis is inflammation, irritation, and swelling of the Achilles tendon (the tendon that connects the muscles of the calf to the heel). There are two large muscles in the calf, the gastrocnemius and soleus. These muscles generate the power for pushing off with the foot or going up on the toes. The large Achilles tendon connects these muscles to the heel.

These are important muscles for walking. This tendon can become inflamed, most commonly as a result of overuse or arthritis, although inflammation can also be associated with trauma and infection.

The most common site of Achilles Tendonitis is at the heel to 4 inches above the heel. The diagnosis of this problem is made when the following signs are present:

  1. Pain in the Achilles Tendon with up and down movement of the foot at the ankle.
  2. Pain in the Achilles Tendon when you squeeze the tendon from side to side.

Self treatment should begin immediately after the injury, with a careful examination of the foot. Make sure that the tendon is not torn through and through. If it is severed, you must seek attention immediately so that the tendon can be repaired. Severe injuries can sever a tendon, without a skin laceration being present. Testing involves moving the toes and foot to see if the tendon moves. If the tendon does not appear to move, it may be severed (comparing the injured tendon and its movement to the same tendon on the uninjured foot may help).

If the above exam is negative, then you may proceed with self-treatment.

The sooner you begin to treat your injury, by following “R.I.C.E.”, the better you will feel:

  • Rest is very important. Take off your shoe, get off your feet, and relax.
  • Ice should be applied as soon as possible. Never apply ice directly on the injurued area, as the cold may make the pain worse. Ice should be applied close to the injured site, between the heart and the injury, so that as the blood flows under the ice, it will be cooled. This cool blood flowing into the injured area will help to reduce the swelling and pain.
  • Compression is used to limit swelling, and to give support to the injured area. Compression should be applied to the entire foot, starting first at the toes and working back to the ankle. If it is applied just to the injured area, increased swelling will occur in front and behind the wrapping.
  • Elevation of the leg will aid in reducing swelling and pain. Blood rushes to an injured area to bring increased blood cells which aid in healing. Gravity will also force blood to the injured area. Too many cells and too much fluid will apply pressure to the injured nerves and tissues, and cause increased pain and delayed healing. Keep your foot elevated so that it is at least parallel to the ground, or higher if it is comfortable. Do this for at least 48 hours, or until the throbbing subsides, when you lower the leg.

If symtoms are not improved with the above regimen or it returns when you resume your regular activity, you need to seek medical attention. Treatments include:

  • Removable Cast Boot or CAM Walker
  • Achilles Heel Guard
  • Custom-Made Orthotics

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