Achilles Tendinitis

Achilles tendinitis is a common condition that involves inflammation of the Achilles tendon, which is the largest tendon in the human body, connecting the heel bone to the calf muscles. It can occur due to overuse or repetitive strain, and it is commonly seen in athletes, runners, and individuals who engage in activities that require frequent jumping or sudden changes in direction.

Case:

Mary is a 35-year-old female who recently started a new exercise program to lose weight. She has been experiencing pain and stiffness in her left heel for the past week, which has been affecting her ability to exercise. Mary is worried that she may have injured her Achilles tendon and seeks medical attention.

Pathophysiology:

Achilles tendinitis occurs when the Achilles tendon is repeatedly subjected to stress, leading to micro-tears and inflammation. Over time, this can weaken the tendon and lead to more significant injuries such as partial or complete ruptures. Factors that can contribute to the development of Achilles tendinitis include:

Overuse or repetitive strain
Tight or weak calf muscles
Sudden increase in physical activity
Poor footwear
Abnormal foot structure or mechanics
Certain medications, such as fluoroquinolone antibiotics
Signs and Symptoms:

The most common symptoms of Achilles tendinitis include:

Pain and stiffness in the Achilles tendon, especially in the morning or after prolonged periods of inactivity
Swelling and tenderness around the affected area
Limited range of motion in the ankle joint
A popping or cracking sensation when moving the ankle
Investigation:

To diagnose Achilles tendinitis, the healthcare provider will typically perform a physical examination and review the patient’s medical history. Imaging studies, such as ultrasound or magnetic resonance imaging (MRI), may be ordered to evaluate the extent of the injury.

Treatment:

The primary goals of treatment for Achilles tendinitis are to relieve pain and inflammation, promote healing, and prevent further injury. Treatment options may include:

Rest and ice: Avoiding activities that exacerbate symptoms and applying ice to the affected area can help reduce pain and swelling.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen may be prescribed to reduce pain and inflammation.
Physical therapy: Exercises and stretches to improve flexibility and strengthen the calf muscles can help prevent future injury.
Immobilization: In severe cases, a cast or brace may be needed to immobilize the ankle and allow the tendon to heal.
Surgery: Surgery may be required in cases of chronic Achilles tendinitis or a complete rupture of the tendon.
Advise:

To prevent Achilles tendinitis from developing or recurring, individuals should follow these dos and don’ts:

Dos:

Gradually increase physical activity levels
Wear proper footwear
Stretch and warm-up before exercise
Strengthen calf muscles
Take breaks and rest when needed
Don’ts:

Overdo physical activity
Wear improper footwear
Neglect warming-up or stretching exercises
Ignore pain or discomfort

Reference:
American Academy of Orthopaedic Surgeons. (2019). Achilles Tendinitis. https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

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