The Achilles tendon is the largest and strongest tendon in the body, and it serves a very important purpose. It connects the gastrocnemius and soleus – the two primary calf muscles – to the back of the heel bone. When too much stress is placed on the Achilles tendon, also known as the heel cord, it tightens and becomes overworked. As a result, it can become inflamed, a condition that is known as Achilles tendinitis.
Over time, scar tissue can develop on the tendon and a tear or rupture can occur. With proper treatment, worsening of the condition can be avoided and can reduce pain so that you can continue to participate in your physical activities. There are two treatment options available for Achilles tendinitis: non-surgical and surgical.
For many people, non-surgical treatment can relieve the pain that is associated with Achilles tendinitis. There are several non-surgical treatment options available, including:
- Physical therapy. The stretching and strengthening exercises that are provided through physical therapy can be quite effective, especially for those who suffer from noninsertional tendinitis.
- Non-steroidal anti-inflammatory medication. Medications like ibuprofen and naproxen can reduce the pain and swelling associated with the condition; however, they do not reduce the thickening of the tendon.
- Cortisone injections. Cortisone is a steroid that has anti-inflammatory properties. While this can be an effective treatment option, it is used cautiously, as it can cause the tendon to rupture.
- Orthotic devices. Orthotic devices can help to reduce the irritation of the tendon. They are particularly effective for people who suffer from insertional tendinitis.
- Stretches. Calf stretches have proven to be effective for treating Achilles tendinitis, as they can help to strengthen the calf muscles and reduce the stress that is placed on the Achilles tendon.
- Bilateral heel drop. This exercise can also help to reduce the stress that is placed on the heel cord. To do this exercise, stand at the edge of a stair or a stable raised platform with only the front of your foot on the surface. Lift your heel and slowly lower it to the lowest point possible. Do 20 reps and make sure to do them slowly.
- Rest. Plain old rest can treat the condition. By resting the Achilles tendon, you will give it the opportunity to heal itself. Completely stop activities until the pain subsides enough for you to participate in low-impact activities. Gradually increase your activity levels.
- Ice after each run. Place ice on the tendon after each run. Ice will reduce the inflammation and ease the pain. Apply ice for 20 minutes.
If the injury does not respond to self-treatment within two weeks, you should see an orthopedic surgeon for further evaluation.
If the pain that is caused by Achilles tendinitis does not improve after six months of non-surgical treatments, surgery may be necessary. There are three main types of surgeries that can be done to treat the condition:
- Gastrocnemius recession. During this surgical procedure, the gastrocnemius muscles in the calf are lengthened. Since tight calf muscles put more stress on the Achilles tendon, lengthening the calf muscle can reduce the pain. This surgery is recommended for people who have difficulty stretching their feet, despite repeated stretching.
- Non-Insertional Debridement. In this procedure, the damaged part of the Achilles tendon is removed. After removing the damaged part of the tendon, the remaining portion is repaired with sutures.
- Insertional debridement and Haglund’s resection. During this surgery, an incision is made on the back of one side of the heel or directly over the heel cord. The inflamed bursa behind the Achilles tendon is removed, as is any inflamed tissue, bone spurs or degenerated parts of the tendon.
If you are suffering from Achilles tendinitis, schedule an appointment with a Nilssen Orthopedics Ankle and Foot Center surgeon by calling 855-998-FOOT or complete our contact form.