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Achilles tendonitis. What is it and how do I get rid of it?

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The North DFW area is a very active community and as foot and ankle specialists, that means that we see a lot of Achilles tendon injuries at our practice. Athletes of all ages and activity levels come to our office seeking relief from these nagging aches and pains around their heels. Our goal is to help our patients get back to the participating in the physical activities they enjoy as quickly as possible.

The Achilles tendon is the largest and strongest tendon in the human body. Connecting the calf muscles to the heel, your Achilles tendon is what allows you to push off the ball of your foot when engaged in physical activity. It is a thick, elastic, and fibrous band of tissue that is able to withstand great force. The immense and repetitive force that it is subject to during athletic activity is also one of the factors that makes it vulnerable to injury. With repetitive stress and overuse, the Achilles can undergo micro tearing of the fibers which leads to structural changes including thickening and hardening of the tendon. This weakens the tendon and makes it less elastic causing irritating pain and inflammation known as tendinitis.

Common factors that place someone at risk for developing Achilles tendonitis

  • Improper shoe selection
  • Inadequate warm up time prior to engaging in physical activity
  • Overly tight calf muscles
  • Abnormal biomechanics during gait such as over pronation
  • Deconditioning or weakening of the calf muscles
  • Irregularities of the heel bone i.e., spur formation where the Achilles tendon attaches

Patients with Achilles tendonitis often present to the clinic describing achiness or soreness at the back of the the heel after physical activity. They also often describe feeling a lump or hardened area within the Achilles tendon itself. Treatment for Achilles tendonitis varies depending on the severity of the symptoms and length of time symptoms have been present.

Common treatments for Achilles tendonitis

  • Rest  
  • Heel cups/heel lifts
  • Night splints
  • Physical therapy
  • Accommodative shoes and/or inserts to correct biomechanics
  • Immobilization in a cast or boot
  • Surgery to lengthen the tendon and/or remove scar tissue and remodel bony deformities of the heel if other non-surgical treatments have not resolved the symptoms
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