The Achilles tendon is a strong band of tissue that joins the muscles of the calf to the bone of the heel. Tendinitis, sometimes spelled tendinitis, is a condition where the tendon becomes inflamed and painful, often due to excessive use in sports such as running. At first the problem may resolve with rest but, if the tendon is not given the chance to heal fully, chronic Achilles tendinitis can result, where the condition does not go away. The Achilles tendon is named after the hero of Greek mythology, Achilles, whose only vulnerable point was his heel. His story also gives rise to the phrase Achilles heel, which is commonly used to refer to a weakness.
Achilles tendinitis is more likely to occur when people change the intensity or type of exercise they do too suddenly, perhaps by taking up a new sport without adequate preparation. Runners training on hard surfaces or with poor running technique may be at risk, as may cyclists who sit in a low position which flexes the ankle excessively. Certain antibiotics can also lead to inflammation of the Achilles tendon. Symptoms of pain, tenderness, swelling and stiffness may be experienced, and a combination of rest, applying ice, taking anti-inflammatory drugs and performing gentle exercises may help resolve them. If care is not taken, the problem becomes long term, resulting in chronic Achilles tendinitis.
In chronic Achilles tendinitis, the problem is more difficult to treat. Sometimes the pain disappears while training, which can encourage athletes to continue, only for the discomfort to return as soon as they stop. The pain no longer improves with rest, and may reach a level where the person is unable to exercise. Tendon degeneration occurs, and small lumps may be felt in the area just above the heel. Increased pain is often experienced first thing in the morning or on walking uphill.
Treatment of chronic Achilles tendinitis is similar to that used for the initial, acute, form of the condition, but methods may need to be adapted for long-term use. For example, if foot problems have exacerbated the injury, a set of insoles may be worn to prevent the feet from rolling inward and placing extra strain on the Achilles tendon. Instead of applying ice, a more permanent cold wrap may be fixed around the inflamed tendon. A program of stretching exercises may be followed, to make the calf muscles more flexible and decrease the pressure on the Achilles tendon. Sometimes the ankle is strapped and, in severe cases, a plaster cast may be used.
It is not currently known which treatments are most beneficial for chronic Achilles tendinitis, but prevention is possible. Especially in older athletes who exercise infrequently, wearing the correct type of shoe for running, warming up before exercise and avoiding abrupt changes in the level of training can all help to prevent tendon damage. Prevention is preferable because, once chronic Achilles tendinitis occurs, it may take months to heal.
