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Alternative Names Return to topTendinitis of the heel
Definition Return to top
Achilles tendinitis is inflammation, irritation, and swelling of the Achilles tendon (the tendon that connects the muscles of the calf to the heel).
Causes Return to top
There are two large muscles in the calf, the gastrocnemius, and soleus. These muscles generate the power for pushing off with the foot or going up on the toes. The large Achilles tendon connects these muscles to the heel.
These are important muscles for walking. This tendon can become inflamed, most commonly as a result of overuse or arthritis, although inflammation can also be associated with trauma and infection.
Tendinitis due to overuse is most common in younger individuals and can occur in walkers, runners, or other athletes, especially in sports like basketball that involve jumping. Jumping places a large amount of stress on the Achilles tendon.
Tendinitis from arthritis is more common in the middle aged and elderly population.
Symptoms Return to top
Symptoms usually include pain in the heel when walking or running. The tendon is usually painful to touch and the skin over the tendon may be swollen and warm.
Exams and Tests Return to top
The doctor will perform a physical exam and look for tenderness along the tendon and for pain in the area of the tendon when you stand on your toes.
Imaging studies can also be helpful. X-rays can help diagnose arthritis and an MRI will show inflammation in the tendon.
Treatment Return to top
Treatment usually involves:
You should limit any activities that make the symptoms worse.
Occasionally, a cast, brace, or boot may be used to keep the heel still and allow the swelling to go down.
If these treatments fail to improve symptoms, surgery may be needed to remove inflamed tissue and abnormal areas of the tendon.
Outlook (Prognosis) Return to top
Conservative therapy usually helps improve symptoms. However, symptoms may return if activities that cause the pain are not limited, or if the strength and flexibility of the tendon is not maintained.
Surgery, if needed, has been shown to be very effective in improving pain symptoms.
Possible Complications Return to top
Achilles tendinitis may make you more likely to have an Achilles rupture. This condition usually causes a sharp pain, like someone hit you in the back of the heel with a stick. Surgical repair is necessary, but difficult because the tendon is not normal.
When to Contact a Medical Professional Return to top
If you have pain in the heel around the Achilles tendon that is worse with activity, contact your health care provider for evaluation and possible treatment for tendinitis.
Prevention Return to top
Prevention is very important in this disease. Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.Update Date: 7/29/2008 Updated by: Thomas N. Joseph, MD, Private Practice specializing in Orthopaedics, subspecialty Foot and Ankle, Camden Bone & Joint, Camden, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.