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Achilles Tendon Pain
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Achilles Tendon Pain

The Achilles tendon (also known as “Heel Cord”) - the longest tendon in the body - runs down the back of the lower leg and connects the calf muscle to the heel bone.  The Achilles tendon aids in walking by helping to raise the heel off the ground. 

Achilles Tendonitis & Achilles Tendonosis
Achilles tendonitis is an inflammation of the Achilles tendon.  Over time if left untreated can lead to a degeneration of the tendon (Achilles tendonosis), in which the tendon loses its organized structure and is likely to develop microscopic tears.  In rare cases, chronic degeneration with or without pain may result in rupture of the tendon.

Symptoms

• Pain - Aching, stiffness, soreness, or tenderness - within the tendon
• Pain appears in the morning or after periods of rest
• Tenderness - when the sides of the tendon are squeezed
• Chronic problems - the tendon may become enlarged and may develop nodules in the area where the tissue is damaged

Causes

• Achilles tendonitis and tendonosis are usually caused by overuse.  A sudden increase of a repetitive activity involving the Achilles tendon, leading to micro-injury of the tendon fibers.
• Athletes and “weekend warriors”are at higher risk for developing disorders of the Achilles tendon.
• In addition, people with pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis.  If these individuals wear shoes without adequate stability, their over-pronation could further aggravate the Achilles tendon.

Diagnosis
In diagnosing Achilles tendonitis or tendonosis, an examination of the foot and ankle including evaluating the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays, ultrasound or MRI.

Treatment

• Immobilization
• Ice
• Oral medication [Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)]
• Physical therapy

If non-surgical approaches fail surgery may be necessary. East Penn Foot and Ankle Associates will select the best procedure to repair the tendon.

Prevention
To prevent Achilles tendonitis or tendonosis from recurring after surgical or non-surgical treatment, East Penn Foot and Ankle Associates may recommend strengthening and stretching of the calf muscles through daily exercises as well as custom foot orthotics.