What Are The Symptoms of Achilles Tendinitis? How Can I Treat My Achilles Injury?

• Tight, weak, or fatigued gastrocnemius (calf) muscles.
• Individuals that overpronate or have flat feet.
• Overuse! Doing too much too soon....excessive hill workouts, dynamic speed work, sled pushing (without gradually working up to it).
• Worn out or inflexible workout or running shoes
• Dynamic directional activities when you are reconditioned and not properly warmed up.

Middle age individuals or weekend warrior that jump out on the tennis, basketball, or latest craze of pickleball need to take extra caution. Essentially avoid explosive, dynamic workouts if you are deconditioned and have not performed these movements for a long period of time. This is difficult at times for aging athletes that were once use to easily performing in these sports. The mind is saying "no problem lets charge after it" but the body is saying "hold on Im not as flaxible/in shape as I once was so lets slow it down.

So what exactly is the Achilles tendon? The Achilles Tendon is a strong fibrous cord that connects the muscles in the back of your lower leg (gastrocnemius and coleus) to the back of your heel (calcaneus). This large tendon helps you point your foot downward, elevate on your toes and push off your foot as you ambulate. Every time you move your foot, chances are you are utilizing your Achilles tendon.

Under too much stress, the tendon can become overworked or overused. This generally leads to inflammation of the tendon or tendonitis. If not addressed, this inflammation can produce scar tissue thus decreasing rang of motion in the tendon. This could lead to potentially more problems. If you overstretch your Achilles tendon, it can tear or even rupture. An Achilles tendon rupture can be partial or complete. Usually the rupture occurs just about your heel bone but it can happen anywhere along the tendon.

Another common problem that can occur is Achilles bursitis. The bursa is a fluid filled sac that secretes lubricant to enable the joint to be smooth and frictionless. Think of it as WD-40 for the body. Inflammation can occur in the bursa between your heel bone and your Achilles tendon. This type of bursitis is termed Retrocalcaneal bursitis.

Achilles tendinitis is the inflammation of your Achilles tendon. When someone asks "Do I have Achilles Tendonitis?" it is typically associated but not limited to these symptoms:

• Pain along the back of the actual Achilles tendon (typically closest to heel)
• Decreased Range of Motion (R.O.M.) at the ankle
• Heat or Redness over the painful area
• Bump of build up of scar tissue that can be fed at the tendon
• Snapping noise from scar tissue when ankle movement occurs

If you happen to experience Achilles tendonitis what can you do? Here are a few treatment strategies we use to do in the physical therapy clinic. 

1. Rest from your activity and sport that potentially triggered the injury.
2. Apply cold therapy, ice massage for 15 minutes several times a day until the inflammation and pain subsided.
3. Massage the knotted area several times a day
4. Stretch the gastroc/soleus area.
5. Consider short term use of aspirin/ibuprofren for pain *only if approved by MD.
6. Work your way back to activity slowly
7. Consider a gait analysis to access your overall foot health.
8. The use of custom orthotic or motion control shoe should be considered along with the above regime.

The toughest part is rest for runners and athletes. The good news is that you can still enjoy aerobic and cardio fitness in a more protected environment. Consider swimming with a pull buoy or aquatic running/exercise in the pool. Consult your local physical therapist for a complete exercise program.