Achilles Tendonitis is a partial degeneration of the tendon tissue which connects the calf muscle to the heel of your foot.  Generally, degeneration or inflammation is felt closer to the heel than the calf.  It exhibits as a common occurrence in stop and start type of sports such as tennis, racquetball, football and basketball. 

                                          Role of the Achilles:

Considered the strongest tendon in your body, when contracted, it enables you to stand on your toes, walk, run or jump. 

Causes of Achilles Tendonitis:

Often considered a repetitive stress or overuse injury the following surfaces or body patterns may bring on the tendonitis:

• Flat feet
• Running hills and hard surfaces
• Misalignment (unequal leg length; short or tight calf muscles)
• Weak calf muscles
• Shoes which don’t provide proper support; high heels over a long period
• Little or no stretching in exercise routine
• Sharp increase in pace of activities involving pushing off, lunges, jumping or running steep hills with less recovery time in between sets
• Overpronation of the foot

Symptoms of Achilles Tendonitis:

Symptoms can be acute (short term and ending a few days after it’s begun) and/or chronic (long term over a period of weeks or months).  It is notoriously slow in healing due to poor blood supply.

Acute:

• Gradual onset
• Initial pain which disappears after warming up but returns when activity has stopped
• Achilles or heel is tender to the touch

Chronic:  (Acute symptoms plus…)

• Pain and stiffness in the tendon, particularly in the am
• Pain in the tendon when walking, going uphill or walking up steps
• Swelling or inflammation over the tendon.  Nodules/bumps can be present
• Crepitus at heel insertion

Treating Achilles Tendonitis:

Few athletes like or want to hear this but rest is crucial for treating the aggravated achilles.   Women should refrain from wearing high heels during this treatment period. 

Treatment should consist of:

• RICE: rest, ice, compression & elevation
• Reduce training by 50% and continue icing
• Consider wearing a heel pad in shoe to relieve pressure on heel and pull on tendon
• Consider alternate exercise such as swimming or moderate biking during this time
• Physical therapy for electrical stimulation and ultrasound to help repair tendon tissue and rehab exercises for strengthening and stretching
• Non-steroidal anti-inflammatories for no longer than 14 days

 Massage can be helpful post-acute phase to the calf muscles which will likely be extremely tight.  Separation of the gastrocnemius and soleus muscles is recommended.