Achilles Tendinopathy

Causes / Diagnosis / Symptoms / Treatment

The Achilles is a strong tendon at the back of the leg. It attaches the calf muscle to the heel. The Achilles is involved in almost all the activities that depend on the lower limb. It has a crucial role in standing, walking, and running. It is also necessary for any jumping activity. The Achilles can commonly be affected by a condition called Achilles Tendinopathy, which is an inflammatory issue of this particular tendon.

The overuse of various activities can result in small tendon injuries. The accumulation of those tiny injuries affects the integrity and the function of the tendon Achilles. Tendons tend to heal slowly, so after every injury to the Achilles, the tendon does not completely recover resulting in further wear and tear and continuous stress/overuse of the tendon.

Causes and Risk Factors of Achilles Tendinopathy

Achilles Tendinopathy is a result of overuse of the Achilles. This results in tiny tears that do not completely heal resulting in this condition. Therefore, activities that involve repetitive stress are on top of the list for causes of Achilles Tendinopathy.

- Some sports have a high risk of developing Achilles Tendinopathy. Running, jumping sports and Tennis are among the risky sports. Also, weightlifting can repetitively put heavy pressure on the tendon. Dancing is also found to be among the physical activities that can lead to Achilles Tendinopathy.
- Wearing unsuitable footwear is one of the risk factors. The reason for that is due to an accumulation of stress on the heel.
- Poor training techniques in addition to abrupt changes in your exercise routine can lead to Achilles Tendinopathy.

Some predisposing factors of Achilles Tendinopathy:

- Achilles Tendinopathy is found to be more common in people with high blood pressure and high blood cholesterol.
- Some medical conditions can involve the development of Achilles Tendinopathy. Among those conditions are Ankylosing spondylitis. This is a condition that affects the joints and the vertebral column causing stiffness and movement limitation. Also, Psoriatic arthritis, which is an autoimmune disease that affects skin and joints.
- People taking medications that belong to a group of antibiotics called Fluoroquinolones have a relatively high risk of developing Achilles Tendinopathy. This group of medications include Ciprofloxacin, Levofloxacin and Ofloxacin.

Symptoms of Achilles Tendinopathy

Achilles Tendinopathy presents mainly with stiffness around the tendon at the lower part of the back of your leg. You will also have pain that is worse in the early morning. Stiffness and pain of Achilles Tendinopathy develop gradually as you put more pressure on the tendon. You might also have pain when you touch the area around the Achilles tendon. This area can also be slightly swollen.

Diagnosis of Achilles Tendinopathy

The diagnosis of Achilles Tendinopathy depends on your medical history and the examination your doctor carries out. Your doctor will be able to diagnose Achilles Tendinopathy based on your symptoms and the findings of the examination. They might ask you to perform some range of motion or orthopedic tests to put stress on the tendon.

Imaging is not usually needed for diagnosing Achilles Tendinopathy. However, your doctor might consider an ultrasound scan or MRI if the diagnosis is not clear.

Treatment of Achilles Tendinopathy

The treatment of Achilles Tendinopathy is usually conservative. Most of the cases improve with treatment in 3 to 6 months.

- Taking some rest is necessary for recovery. However, prolonged periods of inactivity can worsen the injury. After some time you might be advised to start exercising when you are pain-free.
- Over-The-Counter anti inflammatories will help reduce the inflammation and speed up the healing process.
- Applying cold ice packs on the tendon Achilles helps reduce the swelling and the pain.
- Wearing comfortable footwear or putting inserts into your shoes to elevate the heel is recommended.
- Physical therapy to retrain proper gait and muscle function.

If the above treatments fail to treat your condition, some further treatments can be considered.

- Using ultrasound waves to treat the injured Achilles.
- Surgery can be considered to treat Achilles Tendinopathy. Surgery involves one of 2 common procedures to either stimulate healing or remove any fibrous adhesions preventing tendon healing.