Achilles Tendon Problems

Did you know that the Achilles tendon is the largest tendon in the body? As such, there are a variety of issues that can arise from the tendon including Achilles tendinitis, tendinosis, and insertional Achilles tendinitis, among others. What these ailments of the ankle have in common is that they begin with a degeneration of the tendon, generally followed by inflammation and pain.

Achilles Tendinitis
Tendinitis is inflammation of the tendon caused by overuse, heavy exercise on hard surfaces, issues like high-arched or flat feet, and poor footwear. To avoid tendinitis, it’s important to gradually ease into exercise as opposed to starting suddenly. Refrain from rapidly increasing the intensity or duration of activity as well. Tendinitis may also be caused by bone spurs, an extra growth in the bone where the heel and tendon connect. Watch for swelling, tenderness, or pain, and treat tendinitis with rest, ice, compression, and elevation (RICE).

Achilles Tendinosis
Tendinosis is the product of small tears in the tendon, mostly caused by tightness in the tendon itself or in the calf muscle, and often associated with heel spurs as well. Tendinosis occurs when tissue tears cannot heal properly before additional stress from activity. Whereas inflammation signals tendinitis, there isn’t usually swelling with tendinosis. Instead, the tendon becomes weak and more vulnerable to other injuries. Treating tendinosis means breaking the cycle of repeated strain by allowing months for tissues to rebuild. While tendinitis takes weeks to recover, tendinosis may take months.

Insertional Achilles Tendinitis
Insertional tendinitis is caused by wear and tear over a long period of time and can even occur when patients are not particularly active. While Achilles tendinitis and tendinosis are more common in young athletes who do a lot of running and jumping, Insertional Achilles tendonitis tends to occur in patients over 40 whose tendons gradually swell and become painful as they age. With non-insertional Achilles tendinitis, the injury occurs in the middle segment of the tendon. However, with Insertional Achilles tendinitis, the lower portion of the tendon is affected. If pain, redness, or swelling occur where the tendon connects to the bone, it may be a sign of a bone spur.

Generally, these ankle issues are not caused by a specific injury or activity, rather, they arise from repetitive strain. An examination with your orthopedic physician is essential for accurate diagnosis, and to evaluate both nonsurgical and surgical solutions to remedy Achilles tendon problems.