You may first notice that something is wrong after you start a new training routine that involves a lot of running, or if you decide to join your friends for a few games of beach volleyball on Saturday after a week of just sitting at your computer at work. Your body is not used to the extra activity, and after you finish your run or your game, the tendon at the back of your ankle feels achy. When you have rested, it seems to go away, so you stop worrying about it—until the next time it happens.
Is It Inflammation…or Something Else?
Achilles tendinitis is a term applied to a variety of things that could be wrong with this strong tendon. The suffix “itis” implies that there is inflammation present, but this may not always be the case. Inflammation usually doesn’t last long. A few days of rest and anti-inflammatory pain relievers, and you should be able to resume activity. If the pain continues longer than that, there is likely another issue.
Whenever you are active, your tissues experience a certain amount of damage. During rest times, the cells repair themselves and the tissue grows strong again. If you don’t allow enough time for this regrowth to happen, the tendon damage will increase.
Overuse can cause the fibers of the tendon to break down and small tears can develop. If the heel cord becomes too stretched and weak, a strong impact can cause it to rupture completely in two.
Symptoms of Tendon Problems
The tendon can become irritated and uncomfortable, and if scar tissue forms, it stiffens and loses the elasticity it needs to accommodate the way your foot moves. This can result in pain first thing in the morning, because the ankle has been lying still while you slept and the tendon has contracted.
The Achilles is supposed to stretch slightly as you put weight on the foot, but if it is too stiff, that doesn’t happen and the tension causes pain. Pain may also be present when you press on the sides of the heel cord with your fingers. Eventually, the tendon can enlarge or develop nodules in the damaged area, which can also be painful.
How to Treat Achilles Tendinitis
In the beginning, when the inflammation and pain are acute, we may try several conservative options to decrease them. You should rest from activity that would aggravate the problem. We may immobilize the ankle with a boot or brace, and possible prescribe wearing night splints to keep the ankle flexed while you sleep. Anti-inflammatory medication may help relieve inflammation and pain, and so can icing the area a few times a day with a cloth covered ice pack.
We may take a look at your pronation pattern—the way your foot moves as you walk and run—to see whether you could benefit from a pair of custom orthotics. These specially-designed inserts for your shoes give added support to keep your joints stable and lesson tension on the Achilles. Make sure you have supportive shoes that are appropriate for your activity as well, to help prevent further problems.
Physical therapy such as stretches and strengthening exercises can also make calf muscles and tendons more pliable and reduce the tension that is causing your discomfort. If none of the above take care of your issues, we may explore surgical options to repair the tendon.
Find Help for Your Sore Achilles in Berkeley
You don’t have to just live with Achilles tendon pain. In fact, you shouldn’t if you want your feet to stay healthy and mobile. For expert diagnosis and treatment of Achilles tendinitis, set up an appointment with Yuko Miyazaki, DPM in Berkeley, CA by calling (510) 647-3744, or request a time using our online form. When you can run and play sports again without pain, you’ll be glad you did!