Achilles Tendinitis
What causes Achilles Tendinitis?
Achilles tendonitis is an inflammation of Achilles tendon which connects the calf muscle to the heel bone. It’s common in runners and middle aged people who enjoys sports on the weekend so called “weekend warriors.” It often results from microtears that occur in the tendon during strenuous, high impact exercise, such as running. In severe cases, Achilles tendon may rupture which would require a surgical repair.
Achilles Tendinitis Treatment in Frisco, Texas
The Achilles tendon is the strong band of tissue that connects the calf muscles to the heel bone. It plays an essential role in walking, running, climbing stairs, and pushing off the ground. Achilles tendinitis—or Achilles tendinopathy—develops when the tendon becomes irritated or begins to undergo changes from repetitive stress.
Pain may occur in the middle portion of the tendon or where the tendon attaches to the back of the heel. Common symptoms include morning stiffness, tenderness, swelling, thickening of the tendon, and pain that worsens during or after activity.
Diagnosing Achilles Tendinitis
Dr. Woojung Lee will examine the foot and ankle, evaluate flexibility and strength, and determine where the tendon is painful. X-rays may be taken to look for bone spurs, calcification, or other causes of heel pain. Ultrasound or MRI may be recommended when the diagnosis is uncertain, a significant tendon injury is suspected, or surgery is being considered.
Achilles tendinitis is different from an Achilles tendon rupture. If you experience a sudden pop, severe pain, weakness, or difficulty pushing off the foot, seek prompt medical evaluation.
Achilles Tendinitis Treatment Options
Most patients begin with nonsurgical treatment. The appropriate plan depends on whether the condition is insertional or noninsertional, the severity and duration of symptoms, the patient’s activities, and the extent of tendon damage.
Treatment may include:
• Activity modification and temporary rest from aggravating exercise
• Ice, compression, and elevation to help manage pain and swelling
• A guided stretching and strengthening program
• Physical therapy to improve flexibility, strength, and tendon loading
• Supportive footwear and heel lifts to decrease stress on the Achilles tendon
• Custom orthotics created from a 3D scan to address foot mechanics and pressure distribution
• A night splint to maintain calf and Achilles flexibility
• An ankle brace or another offloading device
• Temporary immobilization in a walking boot for more painful cases
• Nonsteroidal anti-inflammatory medications (NSAIDs), when medically appropriate
• EPAT® shockwave therapy
• Selected nonsteroidal injection therapies following a discussion of their evidence, risks, and alternatives
• Surgery for persistent cases that do not improve adequately with appropriate nonsurgical care
Stretching and Physical Therapy
Stretching and strengthening can be important parts of Achilles rehabilitation, but the exercise program should match the location and stage of the condition. Certain heel-drop exercises that may benefit noninsertional Achilles tendinitis can aggravate insertional pain when performed incorrectly.
Dr. Lee or a physical therapist can recommend an appropriate program and show you how to gradually reload the tendon. Returning to running or high-impact activity too quickly may prolong symptoms or increase the risk of reinjury.
EPAT Shockwave Therapy
Modern Podiatry offers EPAT®, or Extracorporeal Pulse Activation Technology, as a nonsurgical option for selected patients with chronic Achilles tendon pain. This form of shockwave therapy delivers acoustic pressure waves to the affected area and is intended to stimulate a healing response in damaged tissue.
EPAT is typically performed in the office and may be combined with physical therapy, activity modification, orthotics, or other treatments. Results vary, and more than one session may be recommended. Dr. Lee will explain the expected benefits, limitations, cost, and alternative treatments before proceeding.
Medication and Injection Considerations
NSAIDs may provide temporary relief from pain and inflammation but do not reverse chronic tendon degeneration. These medications are not appropriate for every patient and should be used according to medical guidance.
Corticosteroid injections directly into the Achilles tendon are generally avoided because they may weaken the tendon and increase the risk of rupture. Other nonsteroidal injection therapies may be discussed in selected cases, but their effectiveness varies and no injection can guarantee tendon healing.
When Is Surgery Considered?
Surgery may be considered when significant pain and functional limitations continue despite an adequate course of nonsurgical treatment. The recommended procedure depends on the location of the problem and the amount of damaged tendon.
Surgical treatment may involve removing diseased tendon tissue, removing a painful bone spur, repairing and reattaching the Achilles tendon, lengthening a tight calf muscle, or reconstructing the tendon in more advanced cases. Recovery varies according to the procedure and may involve a period of immobilization, protected weight-bearing, and physical therapy.
A Personalized Approach to Achilles Pain
Achilles tendon conditions can take several months to improve, even with appropriate treatment. Dr. Lee develops an individualized plan based on your diagnosis, lifestyle, activity goals, and response to care.
Schedule an evaluation at Modern Podiatry in Frisco if Achilles or back-of-the-heel pain is interfering with walking, exercise, work, or daily activities.
