Understanding Achilles Tendonitis: Causes and Treatment

Achilles, the great warrior of Greek mythology, was dipped in the River Styx as a newborn to render him invulnerable, except for his feet, where mother Thetis held him. In the physiology of the foot, the Achilles tendon remains a vulnerable spot. An injury there can make it difficult or painful to move under your own power.

While tendonitis of the Achilles tendon probably won’t mean you’ll be struck down in battle, proper care can prevent more serious strains and tears that may require surgical intervention to repair. Let’s take a look at the function of the tendon, how it is injured, and how effective treatment can help you recover.

The function of the Achilles tendon

The thickest and strongest tendon in the body, the Achilles tendon -- also known as the calcaneal tendon -- connects the calf muscles to the heel bone. About 6 inches long, the tendon extends down from about the midpoint of the calf.

The Achilles tendon absorbs force of up to about four times your bodyweight while moving through the motions of walking. Actions such as running, jumping, and pushing up on your toes also require the use of the Achilles tendon.

Reasons for injury

Damage to the tendon typically stems from repetitive strain or intense force. These conditions can cause irritation or inflammation of the tendon, medically called tendonitis. As you age, the tendon weakens and becomes more vulnerable to injury. Runners frequently have issues with Achilles tendonitis, particularly if they have a change to training, such as adding hills to their runs.

There are specific factors that increase your risk of developing Achilles tendonitis. These factors include:

Achilles tendonitis treatment

The good news with irritations and inflammations of the Achilles tendon is that they respond well to self-care, provided there’s not more advanced damage to the tendon. Tendon injuries typically respond well to the RICE protocol: Rest, Ice, Compression, and Elevation.

Pain typically is well-controlled with over-the-counter pain medications, particularly those in the class of non-steroidal anti-inflammatory medications, such as naproxen and ibuprofen, which can help by reducing inflammation as well as blocking pain.

If your home efforts aren’t producing results, call my offices in Austin or Pflugerville for inspection and diagnosis. A physical exam of your foot is often enough to tell me that your Achilles tendon is affected, and other diagnostic imaging, such as X-Ray, MRI, and ultrasound can also help when needed.

When conservative treatment doesn’t offer results, or if your tendonitis recurs, physical therapy to stretch and strengthen the muscles supporting your Achilles tendon may provide more lasting benefits. Some patients also respond well to orthotic devices that boost the heel and relieve some stress on the tendon.

Surgical repair of the Achilles tendon

Surgery is a last-resort treatment for Achilles tendonitis, usually recommended after months of conservative care that produces few results. When your tendon is torn, surgical intervention may be the only solution.