What is Achilles Tendonitis?
Achilles tendon is the tissue that attaches the calf muscles (gastrocnemius and soleus) with the heel bone called the calcaneus. The tendonitis is caused by overuse of the calf muscles which are responsible for pointing the foot downwards (plantarflexion). It is most common in middle-aged males.
- Years of running
- Sudden increase in physical activity
- Change in running surface
- Poor footwear support
- Excessive pronation (falling arches)
- Excessive muscle calf tightness
Signs and Symptoms
- Pain in heel and ankle
- Improves when warmed up
- Worse when starting activity and afterwards
- Stiffness around the tendon or in calf muscles
- Swelling at heel and ankle
- Rest from aggravating activities
- Use ice for 20 minutes when tendon is painful
- Use shoes with higher heels or use a heel insert
- Gently massaging the tendon by holding it between the fingers and pushing from side to side
Stretching the calf muscles
Eccentric training program
This consists of a warm up preferably on a bike for 5 to 10 minutes followed by stretching the calf. The eccentric exercise is performed with both heels hanging off the edge of a step, on pointed toes (plantar flexion) with knees extended. The patient then controls the movement until the heels drop below the step (dorsiflexion). The patient should perform 5×10 repetitions with a rest between each of the five sets. The patient then finishes the strengthening with stretching and ice for 20 minutes. It is critical that patient uses the uninjured calf to push up to the pointed toes position to avoid further damage to the injured tendon. This can be progressed by using only the injured leg or adding a backpack with weights.