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Achilles tendinitis causes pain along the back of the leg near the heel. The Achilles tendon is the largest tendon in the body and it connects the calf muscles to your heel bone. Anytime you walk, run or jump, the Achilles tendon is used and can withstand great stresses. However, due to the high stresses, overuse and degeneration, it is prone to tendinitis.
Tendinitis is inflammation of a tendon. Inflammation is the body’s natural response to injury or disease. There are two types of tendinitis of the Achilles depending on which part of the tendon is inflamed.
- Noninsertional: fibers in the middle portion of the tendon have started to breakdown with tiny tears, swell and thicken. This tendinitis commonly affects younger, active people.
- Insertional: involves the lower portion of the heel, where the tendon attaches to the heel bone.
Tendinitis of the Achilles is not related to a specific injury and can occur at any time, even in patients who are not active. It’s often the result of repetitive stress to the tendon. Sudden increase in the amount or intensity of exercise, tight calf muscles and bone spurs can aid in the likelihood of someone developing tendinitis.
Achilles tendinitis symptoms
- Pain and stiffness along the Achilles tendon in the morning
- Pain along the tendon or back of the heel that worsens with activity
- Severe pain the day after exercising
- Thickening of the tendon
- Bone spurs
- Swelling that is present all the time and gets worse with activity.
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Achilles tendinitis treatment
The majority of cases can be treated without surgery. However, even with early treatment, it may take three to six months for pain to completely subside. Nonsurgical treatment options include: rest, ice, anti-inflammatory medications such as ibuprofen, exercise with a focus on calf stretches, physical therapy and immobilization.
Surgery may be recommended by your physician if pain does not improve after six months of nonsurgical treatment. Your orthopedic physician will determine the best surgery options for you.
Surgery is dependent on the location of the tendinitis. Non-insertional tendinitis is more likely to respond to nonsurgical treatment. In cases where pain does not resolve, surgical treatment usually includes debridement and repair of the involved tendon; sometimes accompanying a tendon transfer.
For insertional Achilles tendinitis, surgical treatment typically involves debridement of the involved tendon as well as its insertion, with possible reattachment of the tendon.
After surgery, it is important to keep the weight off the tendon for several weeks to allow for recovery. It usually takes 6 to 12 months for complete recovery after surgery.