The Achilles tendon is the longest tendon in the body and connects our calf muscle to our heel bone. Due to its poor blood supply (see the historical tidbit below), Achilles tendon issues are common. There are usually two types of Achilles tendonitis we see:
1. Non-insertional Achilles tendonitis (the pain in the tendon kind). This pain usually affects our younger, more active patients. They will feel sore or stiff in the morning and get worse throughout the day. You might even see a swelling or feel a bump along the middle of the tendon. This is caused by the fibers degenerating and thickening due to overuse.
2. Insertional Achilles tendonitis (pain at the back of the heel bone) can affect anyone. Again, you’ll experience morning stiffness and increasing soreness throughout the day. Usually patients have tight calf muscles and can develop a bone spur where the Achilles tendon inserts into the bone.
Starting treatments for both types of Achilles tendonitis are the same. Resting, icing and anti-inflammatory medication will help with pain.
Stretching or physical therapy can help to ease pain and lengthen the tendon. Inserts for your shoes or heel lifts can lessen the demand on the tendon. Cortisone injections are rarely done in this area.
Beyond those treatments, there is always surgery to correct the problem. There are two types or surgery for Achilles tendonitis: debridement of the thickened tendon or removal of a spur, if present. Both are very successful but do require a period of non-weight bearing after surgery.
If you are experiencing Achilles tendon pain, don’t wait to seek treatment! If caught early, the Achilles tendon is much easier to treat than if treatments are started later.