Clashing With The Enemy: Achilles Tendinitis
- Ricardo Pacheco PT, DPT
- Jul 25, 2022
- 4 min read
Updated July 21st, 2022
Introduction / Anatomy / Tendinitis /
Introduction
Alright yea so I am sure you all have heard about the famous term “achilles heel” and how it signifies a weakness in spite of overall strength, which can lead to downfall (1). Which OF COURSE comes from the Greek mythological hero Achilles, son of mortal Peleus. Who OF COURSE was the bravest, handsomest, and greatest warrior of the army of Agamemnon in the Trojan war; as depicted by Mr. Brad Pitt in the 2004 classic film Troy, where he so famously won the teen choice award for choice movie actor in a drama. OF COURSE we all know that. But if not, seriously go watch Troy, a pretty epic movie that sums it all up (you will thank me later). Anyways, do not fear! No history lessons will be taught here. Instead we will be going over the EXTREMELY common diagnosis of achilles tendinitis, so fasten your seatbelts it's gonna be a trojan horse of a ride.
Brief Anatomy
Before we dig a little deeper, let's go over some basic but important anatomy. It is important to note that a tendon is fibrous connective tissue that connects a muscle to a bone. The achilles tendon happens to be the largest and strongest tendon in the human body (2). So it is fair to say it is quite an important structure. As mentioned it connects a muscle to a bone; so in this case it is connecting the muscles of the calf (gastrocnemius and soleus) to the heel bone (calcaneus). End of my anatomy lesson. Short, sweet and to the point!
What is Achilles Tendinitis
The achilles tendon becomes irritated and inflamed when exposed to overuse and excessive chronic stress. You may also come across the word achilles tendonosis, which means that the condition has become more chronic. Tendinitis defines a more acute injury. Essentially they are both common terms that are referring to a similar issue. So you may ask how did this issue start in the first place? That's a great question. As mentioned it is an overuse injury that is typically associated with repetitive stress on the tendon. This is important to note because many people who have pain anywhere in the body associate it to a specific event that caused the injury. But achilles tendinitis develops overtime, which can be frustrating for patients who can't pinpoint the specific day and time of the injury.
So How Did This Happen to ME?!
There are several different causes of this condition, but as I have mentioned earlier it is most commonly associated with overuse and chronic stress. With that being said, I am gonna just say it…our bodies are ALL different than they were back in our middle/high school days. Yes, we all know that if only the coach would have put you in that game you would have won the state championship, but those days are in the past!! While we age, movement and healing tends to become more difficult. Sometimes in life we gain the freshman fifteen, we put on the grad school twenty, we pick up the Covid nineteen (pounds) or like in my case all three!! So why is this all relevant? Because our bodies try their best to adapt to change, but we tend to over push them. The achilles tendon is a very strong structure, but it supports most movements we complete on a day to day basis.
Common Causes/ Risk Factors:
An abrupt increase in intensity or amount of exercise performed. This could be individuals who are trying to get back into shape but begin too aggressively.
Frequent running on uneven surfaces.
Individuals with jobs that require them to be on their feet all day.
Individuals who participate in sports less frequently and attempt to jump back into it (weekend warriors).
It is more common in men.
It is more common with individuals who have flat feet.
Tightness of the calf muscles.
Improperly fitted/old footwear (2).
Signs and Symptoms:
Pain in your ankle or heel
Stiffness/tightness of calf muscles
Increased pain in the morning
Swelling around your ankle
Helpful Tips:
Ease into exercise, don't go 100% immediately. If trying to get back into an exercise routine, think about walking first, then progress from there.
Make sure you are wearing proper footwear, If you have been using the same pair of shoes for years and they look beat up it is probably time to change them out (contact us if you need recommendations).
PLEASE make sure you are stretching before exercising. Below I will post stretches that will be useful for a proper warm up.
Ice after a workout to help control swelling and inflammation (refer to heat and ice article for more information).
What Can Be Done?!
Even with all the information provided, it is always important to consult with a healthcare professional first to be properly diagnosed. The following exercises are just a few that I have used and seen success with patients that I have treated, however can vary with different cases.
Gastroc & Soleus stretch
Eccentric heel raises
4-way ankle strengthening
Conclusion
So you have made it all the way to the end! That wasn't too bad right?! Anyways, it is important to understand the basics of achilles tendinitis in order to properly treat it. Though this diagnosis is quite common, it may present differently depending on the individual. It is always important to consult with a healthcare provider before self diagnosing. Please feel free to reach out to any of us with any questions or concerns.
References
Achilles heel | meaning in the Cambridge English Dictionary". dictionary.cambridge.org. Retrieved 2019-09-29.
Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. American family physician. 2005 Sep 1;72(5):811-8.
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