Treating Achilles Tendon Injuries & Chronic Pain
Medical diagnosis & effective pain relief at 4 Milwaukee podiatry clinics
Get prompt, professional treatment for Achilles tendon pain to give yourself the best chance of a full recovery.
The Achilles tendon connects the calf muscle to the back of the heel bone. It’s the longest, strongest tendon in the human body.
When you flex your calf muscles, the Achilles tendon pulls the heel – this is how we can point our toes, jump, and run on the balls of our feet.
The Achilles tendon carries a heavy load and handles plenty of tension. This can make it prone to injury, especially in people who only exercise occasionally (more likely to overdo it) and older adults (wear and tear).
Because tendons have a limited blood supply (compared to muscles) they can take much longer to heal. It’s important to treat every tendon injury or strain as early as possible, and give yourself plenty of time to recover before resuming normal activities.
What is Achilles tendonitis?
While most common in people exercising or playing sports, anyone can develop Achilles tendonitis or an Achilles tendon injury, at any age or activity level.
Insertional Achilles tendonitis occurs in the lower part of the heel, right where the Achilles tendon connects to (inserts) the heel bone. There is often calcification and degeneration at the enthesis (the point where the tendon meets the bone) and patients may notice a bump or lump just behind the heel bone. Heel spurs can also form with this type of tendonitis.
Non-insertional Achilles tendonitis involves pain and swelling in the fibrous part of the tendon above the talus insertion site. The Achilles tendon fibers suffer small tears and begin to break down. This is the more common type of tendonitis in younger or more active patients.
Achilles tendon rupture is what it sounds like, though a mild form of this injury can also be confused with Achilles tendonitis. The Achilles tendon can rupture (tear) partially or completely from repetitive stress or sudden injury.
There are other conditions affecting the Achilles tendon, including tendinosis (thickening without inflammation) and peritendonitis (inflammation and pain in the tissues around the tendon).
Do I have Achilles tendonitis?
Symptoms of Achilles tendonitis can include:
- Pain down the back of the leg to the heel
- Swelling at the back of the heel
- Stiffness / limited range of motion
- Tight calf muscles
- Inflammation / warm skin in the heel area
Diagnosing Achilles tendonitis typically involves discussion of symptoms, observing the affected area while walking or standing, pinpointing the most painful part and in some cases imaging tests such as X-rays, MRI scans or an ultrasound.
Should I see a podiatrist or an orthopedist for Achilles tendonitis?
In many cases, leg injuries resulting from a foot or ankle condition are treated by a podiatrist. Our team of elite podiatrists are highly experienced in treating Achilles tendon problems and able to perform surgery and prescribe medication, orthotics, and/or physical therapy as needed.
Because podiatrists have highly specialized medical training, they’re typically the best go-to doctor for diagnosis and treatment of conditions affecting the feet and ankles.
Orthopedists are also specialists, of the musculoskeletal system.
Compared to women, men are five times more likely to suffer Achilles tendon rupture.
Causes of Achilles tendon pain
The most common cause of Achilles tendonitis is excessive exercise. This could be anything from overtraining by serious athletes to taking a long walk when you’re not used to walking very much.
Risk factors for tendonitis:
- Skipping warmups before working out
- Repeatedly straining the calf muscles
- Activities like tennis or basketball with a lot of sudden stops and change in direction
- Jumping in to a new exercise routine from a sedentary lifestyle
- Worn out or ill-fitting shoes
- Wearing high heels for a long time, over long periods of time (it can cause the Achilles tendon to shrink, making it more vulnerable to tears when the high heels come off)
- Getting older (your Achilles tendon weakens along with the rest!)
Certain diseases like Crohn’s, lupus, rheumatoid arthritis and infection can also cause Achilles tendonitis. It’s important to get a professional medical evaluation of chronic or acute pain the back of the heel to rule out serious causes (and keep symptoms from getting worse).
Treating Achilles Tendonitis
Treatment for Achilles tendonitis or rupture varies depending on the underlying cause and overall health of the patient. Treatment can range from RICE (Rest, Ice, Compression, Elevation) after a tendon injury to surgery to repair a ruptured tendon.
Other treatments your podiatrist may recommend:
- Reducing or modifying physical activity
- Stretching and strengthening the calf muscles
- Wearing a boot or brace to limit heel movement/impact
- Pain medication and/or anti-inflammatory medication
- Special shoe with a built-up heel to relieve tension on the Achilles tendon
Your podiatrist will develop a personalized treatment strategy based on your symptoms, general state of health, lifestyle and cause of the tendonitis.
Our team of doctors includes an orthopedic surgeon. If tendon rupture surgery is necessary to repair injury to the Achilles tendon, we’ll go over the options for different procedures including cost and recovery time.
Preventing Achilles Tendonitis
There’s no single sure-fire way to prevent Achilles tendonitis or rupture, but you can reduce your risk. Our podiatrists recommend:
- Stretching your calf muscles before and after working out, or after sitting/lying down for long periods
- Gradually take on new exercises and activities, giving your Achilles tendon (and the rest of your body) time to adjust
- If you do high-impact exercise, include some low-impact activities like swimming or biking to reduce stress on your Achilles tendon
- Wear quality, properly-fitting athletic shoes
- Don’t bounce while stretching, and avoid running up hills (both place a lot of strain on the Achilles)
- Reduce weight if obese (excess weight strains tendons)
- Reduce height of high heels gradually to give the tendon time to stretch
Depending on your overall health and the cause of your Achilles tendonitis, your podiatrist may have additional or different recommendations for preventing further tendon problems.
Expert diagnosis & treatment of Achilles tendonitis in Milwaukee
With five Milwaukee-area podiatry clinics and relationships with many area hospitals, Advanced Foot & Ankle of Wisconsin makes it easy to get the care you need.
Schedule an appointment with an experienced podiatrist the first time you experience pain or swelling at the back of your heel. Ignoring Achilles tendon injuries or chronic pain can lead to severe pain, difficulty walking, deformation of the heel bone/tendon area, or reinjury.