The most frequent reason for Achilles tendonitis is overuse. Activities such as walking, running, or sports that involve jumping (basketball, dancing, gymnastics, tennis) can put stress on the Achilles tendon. In fact, the simple act of running produces forces up to eight times body weight across the Achilles tendon, causing significant repetitive stress of the tendon which can cause injury. Achilles tendonitis is common in people who try to increase their activity level too quickly, or return to a vigorous workout regimen after a period of time without activity. It can also be caused by a lack of flexibility in the calf muscles, which causes additional stress across the Achilles tendon.
The first sign of Achilles tendonitis is usually mild pain after running or other exercise. As symptoms progress, this pain may become more intense and more localized, commonly with a point of maximal tenderness approximately 1.5 inches above the insertion of the Achilles tendon on the heel bone. It is not uncommon for the pain to improve with exercise as the tendon warms up, and return after cessation of activity. There can also be mild swelling or redness of the skin around the tendon.
Although an MRI can sometimes visualize inflammation of the Achilles tendon, this test is not necessary for simple cases of Achilles tendonitis, which normally is a clinical diagnosis. However, there are several other conditions such as a partial tendon rupture or heel bursitis that can present similarly, so you should visit your orthopaedic surgeon for an accurate diagnosis.
Rest or activity modification (swimming or cycling instead of running)
NSAIDs (ibuprofen, naproxen, etc.)
Heel lift to reduce tension on the Achilles tendon
Physical therapy to stretch and strengthen the muscles of the lower leg
Surgical treatment to remove fibrous tissue from the tendon sheath – this is used only in advanced cases unresponsive to conservative treatment
Tendonitis in any part of the body is very common in people who increase their activity level too quickly, or fail to warm up properly before strenuous activity. Be sure to use properly fitting equipment (e.g. running shoes) and correct training techniques to avoid this common problem!