What Is Achilles Tendinitis?

Achilles tendinitis is inflammation of a achilles tendon. Inflammation is the body’s natural response to injury or disease, and often causes swelling, pain, or irritation.

There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.

Noninsertional Achilles Tendinitis

In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.

Tendinitis of the middle portion of the tendon more commonly affects younger, active people.

Insertional Achilles Tendinitis

Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.

In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden).

Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.

Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.

What Causes Achilles Tendinitis?

A tendon is a strong, rope-like structure that connects muscle to bone. When the muscle contracts, it pulls on the tendon, which in turn moves the bone. The

Achilles tendon is the largest and strongest tendon in the body. It links the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). This muscle/tendon unit produces the majority of force that pushes the foot down during walking or running.

• Body Weight – excess body weight puts more stress on the Achilles Tendon with walking and activities

• Sudden increase in the amount or intensity of exercise activity—for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance

• Tight calf muscles—Having tight calf muscles and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon

• Bone spur—Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain

What Are The Symptoms of Achilles Tendinitis?

What Are The Treatment Options For Achilles Tendinitis?

The surgical repair of an acute or chronic rupture of the Achilles tendon typically occurs in an outpatient setting. This means the patient has surgery and goes home the same day.

Numbing medicine is often placed into the leg around the nerves to help decrease pain after surgery.  This is called a nerve block.

Patients are then put to sleep and placed in a position that allows the surgeon access to the ruptured tendon.

There are a variety of ways to repair an Achilles tendon rupture. The most common method is an open repair. This starts with an incision made on the back of the lower leg starting just above the heel bone.

If the tendon is not completely ruptured, it may just need to be cleaned out.  In this case, an incision is made into the tendon and the damaged tissue removed.

After the surgeon finds the two ends of the ruptured tendon, these ends are sewn together with sutures. The incision is then closed.

Another repair method makes a small incision on the back of the lower leg at the site of the rupture. A series of needles with sutures attached is passed through the skin and Achilles tendon and then brought out through the small incision. The sutures are then tied together. The best surgical technique for your Achilles rupture will be determined by your orthopaedic foot and ankle surgeon.

Repair of an acute rupture often takes somewhere between 30 minutes and one hour.

Repair of a chronic rupture can take longer depending on the steps needed to fix the tendon.

Recovery after surgery may require 6 weeks in a cast or boot followed by 3-6 months of physical therapy and home exercises.