Achilles tendinitis is when there’s irritation and inflammation in the Achilles tendon, a large tendon that attaches your calf muscles to your heel bone, or calcaneus. You use the Achilles tendon to jump, walk, run, and stand on the balls of your feet. Overusing or damaging this area can lead to Achilles tendinitis.
Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It’s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.
Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your doctor’s supervision
There are two types of Achilles tendinitis:
• Noninsertional Achilles tendinitis involves small tears in the fibers of the middle portion of your tendon and tends to affect younger adults who are active.
• Insertional Achilles tendinitis affects the lower portion of your tendon where it attaches to your heel bone. It can affect people of any age, including individuals who aren’t physically active.
The main symptom of Achilles tendinitis is pain and swelling in the backside of your heel when you walk or run. You may also have tight calf muscles and limited range of motion when you flex your foot.
Common symptoms of Achilles tendinitis also include –
• pain in your heel or behind your calf when you touch or move it
• pain or swelling in that area that worsens when you’re walking or running, or the day after you exercise
• discomfort or swelling in the back of your heel
• limited range of motion when flexing your foot
• stiffness and soreness in the Achilles tendon when you wake up
• warmth around the heel or along the tendon
• difficulty standing on your toes
• thickening of the Achilles tendon
Common causes of Achilles tendon pain are –
• Achilles tendinitis, inflammation (irritation) of the tendon.
• Achilles tendinosis, when the tendon starts to degenerate (break down) because of unresolved Achilles tendinitis.
• Achilles tendon rupture, a tear or break in the tendon.
Risk Factors –
Achilles tendinitis can happen to anyone. However, you may be at higher risk if you –
• try a new sport
• begin exercising more frequently or more intensely
• work out on an uneven surface
• wear inappropriate shoes while exercising
• have bone spurs on your heel
• have tight or weak calf muscles
• take fluoroquinolone, a class of antibiotics
• have diabetes
• have a body weight that’s higher than typical
In general, Achilles tendinitis is more common among men and people age 30 and up.
Achilles tendinitis can weaken the tendon, making it more vulnerable to a tear (rupture) — a painful injury that usually requires surgical repair.
During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range of motion and reflexes of your foot and ankle.
Your doctor may order one or more of the following tests to assess your condition –
Your doctor will first recommend nonsurgical treatment. It may take a few months for the pain to get better — especially if you’ve already had symptoms for a few months.
▪︎ RICE method
• Rest: Stop doing activities that stress your tendon. Switch to low-impact activities, such as swimming, that put less stress on the Achilles tendon.
• Ice: Put ice on your tendon for up to 20 minutes, as needed throughout the day.
• Compression: Compress, or put pressure on, the tendon using an athletic wrap or surgical tape.
• Elevation: To reduce swelling, lie down and raise your foot on pillows so it’s above your heart.
▪︎ Protect your tendon.
Avoid walking up steep inclines or overstretching the tendon, such as by standing on a ladder rung. Wear –
• Supportive shoes, heel lifts or custom orthotics. Don’t walk barefoot.
• Splint at night to help the Achilles tendon stay stretched while you sleep.
• Walking boot or walking cast if the pain is severe.
▪︎ Other nonsurgical treatments
• Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Don’t take the medication for more than one month without talking to your provider.
• Exercises you can do at home, such as calf stretches.
• Physical therapy, which uses strengthening exercises, massage, stretching and running re-education to help you feel better and regain your strength.
• Shockwave therapy, which uses strong sound waves to reduce pain and promote healing.
• Warm up before you exercise or play sports. Focus on stretching exercises, especially stretching your calf muscles.
• Do a variety of exercises to avoid repetitive stress on the Achilles tendon.
• Increase the length and intensity of your exercises slowly rather than all at once.
• Keep your muscles active by staying in shape all year round.
• Wear supportive shoes that fit well.
• Avoid running uphill or on uneven ground.
Ayurvedic Perspective –
Since its origin is mechanical, this comes under Aaganthu Kshtaja vikara and can be managed effectively within a week of treatments . Treatments include external paste applications, heat modalities and partial immobilization depending upon severity of injury and age of patient. This comes under paittika vikara in acute stage and becomes vata kapha vikara in chronicity.
Home Remedies –
Equal amount of Eranda taila (castor oil) and Sarshapa taila (mustard oil) are taken and warmed. This is applied to a cloth and wrapped around the lesion. The fine powder of wheat and Shunthi (ginger) is mixed and by adding little warm water thick paste is made. This is applied around the affected area of Tendinitis.
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