What is Achilles Tendonitis?

What is Achilles Tendonitis?

Achilles Tendonitis is a simple condition that occurs when this specific tendon becomes overused. This section of tissue is basically designed to connect your heel bone with the calf muscles in your leg. Because this area of your leg basically supports much of your weight and is used a lot in everything from basic activities like walking to playing tennis, this tendon can easily become injured. In fact, this is one of the most common injuries found in athletes of any kind, particularly runners.

While this injury can occur in a person of any age, people that are older than 40 have a higher chance of obtaining this injury when playing sports. The inflammation of this tendon can create a lot of pain and irritation. There are two basic types of this condition to look out for. The first is referred to as non-insertional tendinitis. This type occurs in the middle portion of the tendon and is typically found in younger people. The second type is known as an insertional tendinitis. It takes place at the lower part of the heel, just at the point where the heel joins with the tendon. No matter which type of Achilles Tendonitis you suffer from, the pain can range from mild to severe.

What Causes of Achilles Tendonitis Exist?

There is a myriad of causes for Achilles Tendonitis. This condition typically arises through exercising or walking on a regular basis. If these activities become excessive, the tendon can become overused and inflamed. While exercise is the primary cause for Achilles Tendonitis, there are several factors entirely separate from exercise that could also lead to the development of this condition.

For instance, an infection in the area or even arthritis can create a case of Achilles Tendonitis in the area. Since overuse of the tendon can lead to an injury of this type, it can be determined that any type of activity or exercise that causes undue amounts of strain on this tendon could cause Achilles Tendonitis. Some of the most common causes seen with this type of injury include exercising without first warming up, playing any type of sport that calls for you to switch directions suddenly, wearing shoes that don’t fit properly, wearing high heels on a daily basis and overusing the calf muscles through repeated exercises.

This type of injury also occurs a lot among people that haven’t been working out for quite some time and want to make up for that in one fell swoop. Tendons and muscles throughout the body need to be worked gradually into better condition. If the Achilles tendon is pushed too much before it’s been given time to grow in strength, the additional burden on the tendon will cause it to become inflamed and injured.

What are Achilles Tendonitis Symptoms?

There is a myriad of symptoms related to Achilles Tendonitis. The most obvious of these symptoms is the basic pain in the area, which can be anywhere from mild to severe. If you wake up to pain and a general stiffness is this area, it’s clear that you’re suffering from a case of Achilles Tendonitis. While this pain could be a result of some other problem, tendonitis is the most likely diagnosis if the pain is worsened when you attempt to workout or exercise in any meaningful amount.

You may also notice that the tendon becomes noticeably thicker when suffering from this injury. This is due to the onset of inflammation. One of the more obvious symptoms of this condition is if the pain is suddenly severe in nature the day after exercising. An increase in inflammation will lead to an increase in severity. This is why it’s so important to seek treatment the moment you believe that you’re going through tendonitis.

A bone spur where the tendon meets the heel bone is a common sign of insertional tendinitis, while swelling is also a huge problem with this injury. Swelling typically worsens as the day goes by, even with minimal amounts of stress on the tendon. There are also times when you may tear your Achilles tendon, which is a much worse issue that requires treatment immediately. This will be preceded by a notable pop at the heel or calf.

How to Prevent Achilles Tendinitis

By utilizing some important tips for Achilles Tendonitis prevention, you will be able to greatly reduce your chances of suffering from this issue. As touched upon previously, it’s essential that you gradually ease into a routine that you’re considering adding into the rotation of exercises you partake in. If you make the exercises more intense over a lengthy period of time, the tendon will strengthen in accordance with the intensity. You also might want to consider stretching the muscles in this area at the very beginning of every day. Not only does this lessen the chances that you suffer from this type of injury, it will also boost the ability you have. Stretching this area of the body before each workout is also heavily recommended for prevention.

In fact, it’s absolutely essential for any athlete that participates in sports. If you wish to stretch this particular tendon, simply stand straight up, making sure to keep your heel on the ground, and lean forward. Several repetitions of this stretch will warm up the tendon and help you avoid the development of Achilles Tendonitis. When wearing shoes, especially shoes you use to workout or play sports in, it’s important that the shoes are heavily cushioned and include proper arch support. Shoes that have been worn for a lengthy period of time will need to be replaced with newer ones, as the arch support and cushion within any pair of shoes will only deteriorate with time.

If you’re looking to exercise on a daily basis, it can be tricky to avoid the issues that lead to the development of Achilles Tendonitis. However, by mixing up your high intensity workouts with lower intensity workouts, like swimming, you will provide this tendon with a chance to recuperate after stress has been placed on it. Lastly, if you’re considering switching from high heels to flats, this should be a gradual process. Doing so provides the Achilles tendon with the chance to stretch and boost its range of motion.

How to Treat Achilles Tendinitis

There is a bevy of treatments available for you as a means of treating Achilles Tendonitis. These fall into two distinct categories, nonsurgical treatments and surgical treatments. In most cases, surgical treatments are unnecessary unless the condition is particularly severe. It’s important that you seek treatment as early as possible. If you do so, the nonsurgical treatment methods will likely take full effect in less than three months. However, if you wait for a couple of months until you get the problem checked out, the resolution of your injury can take up to six months. Rest is something that everyone suffering from Achilles Tendonitis needs to do.

Until the condition is eliminated, heavily reduce exercising and other physical activities that could put stress on the area. You should also consider using ice as a means of treating the problem. Simply apply ice to the area any time the inflammation is flaring up. Gentle calf stresses and using supportive shoes can also help a lot in reducing the pain. Physical therapy is also extremely helpful with this condition, especially non-insertional tendinitis.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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