Achilles tendinopathy is a condition that affects your Achilles tendon, causing pain. (Remember, the Achilles tendon runs along the back of your calf, attaching to your heel bone.) More common in younger, active individuals, Achilles tendinopathy is an overuse injury, often but not always related to sports or athletic activities.

But what causes tendinopathy, can it be prevented, and once you have this condition, how can we treat it? We’ll explain all that in a minute. But first, let’s get a quick refresher on the way tendons work in your body.  

What are tendons and how do they work?

Tendons are located throughout your body. They are bands of connective tissue that connect your muscles to your bones. As the largest tendon in your body, the Achilles connects your calf muscle to your heel bone (calcaneus). It plays a crucial role in your ability to lift your heel when walking or running. It also allows you to stand on your tiptoes.

When all is going well, your Achilles tendon performs its duties seamlessly. If, however, outside or internal forces puts pressure on the tendon, irritation can develop and problems will begin.

What causes Achilles tendinopathy? Pain in the heel caused by Achilles tendinopathy

Several different factors can lead to this condition.  Often, tendinopathy is the result of overuse. Basically, when you repeat the same motion again and again—by running, jumping, or even just shooting hoops in excess—you stress out the tendon. Soon, it develops tiny tears; in fact, it may even degenerate, causing tendinopathy.

Inflammatory arthritic conditions such as ankylosing spondylitis or psoriatic arthritis can also lead to inflammation in the tendon. And having flat feet, or feet that overpronate (turning inward when you walk) can lead to Achilles tendon problems. (In both cases, your flattened or rolling arches tug at your calf muscles. This puts lots of strain on the Achilles tendon, leading to pain, inflammation and swelling.)

Certain lifestyle factors can increase your risk for tendinopathy. The footwear you choose can contribute to the condition. If you walk or run in shoes without enough support, problems can develop. And you may also trigger tendinopathy by wearing overly flat shoes or shoes with very high heels.  Carrying extra weight can lead to Achilles tendon pain, since the additional pounds may strain your tendon (along with other parts of your body.) And taking certain medications or antibiotics can increase your risk for tendinopathy immediately afterward.  

Identifying Achilles tendinopathy symptoms

Achilles tendinopathy symptoms include:

•    Pain in the back of your heel
•    Difficulty and discomfort when walking
•    Warmth, tenderness or swelling along your Achilles tendon

Often a progressive condition, we can diagnose your tendinopathy according to the severity of your symptoms. Mild tendinopathy means that you experience Achilles pain when you’re active, or shortly after completing an activity, but not at other times.  If your condition is moderate, you may notice swelling in the tendon. And some patients may develop a nodule, or hard lump, in the tendon. Finally, if your tendinopathy is severe, you’ll experience tendon pain any time you partake in a weight-bearing activity. Left untreated, you could even suffer a rupture of the Achilles tendon, often requiring surgical repair.

Diagnosing Achilles tendinopathy in Powder Springs, GA

Dr. Alvin Cowans, a podiatrist in the Lost Mountain neighborhood of Powder Springs, uses various methods to diagnose tendinopathy when you come into the office. First, he’ll take your medical history, making sure to discuss the shoes you wear and the frequency and kind of exercise you do. Next comes a physical exam, where he’ll focus on the Achilles itself, looking for tenderness or noticeable thickening of the tendon.
Finally, if your diagnosis is still unclear, he may order additional tests, include x-rays, blood work, ultrasounds or MRIs. Together, these can help determine the precise cause of your symptoms, allowing Dr. Cowans to create the proper treatment plan.

Treating Achilles tendinopathy

After an Achilles tendinopathy diagnosis, our treatment plan will aim to reduce stress on your tension. In combination, this will heal your current injury and prevent future problems. When treating tendinopathy, we may recommend one or more of the following options:

  • Rest
  • Non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen
  • Physical therapy that includes stretching and strengthening exercises
  • Taking a break from triggering activities such as running
  • Icing the area for 20 minutes every hours, whenever you experience Achilles tendon pain
  • Getting you fitted for custom orthotic devices

Remember, even with the perfect treatment plan, your recovery may be slow. Still, following your specific care instructions will help you heal faster. However, if conservative treatment plans are not providing you relief, we may recommend surgical treatment, since we can’t use injections to treat Achilles tendon pain, due to the risk for a complete tendon rupture.

When surgery is necessary

In rare cases, we’ll treat tendinopathy surgically. But we only do so when all other treatments have failed. During this procedure, we would remove badly damaged sections of tendon. And, if you’ve experienced an Achilles rupture, we re-attach your tendon to allow for healing.

Shortly after surgery, you’ll begin rehab, focusing on stretching and strengthening the area.  Most patients can resume normal activities about 10 weeks after Achilles tendinopathy surgery. But don’t expect to get back into competitive athletic play for between three and six months following surgery.

Preventing tendinopathy

Want to avoid Achilles tendon pain instead of working your way through recovery? Here are some important suggestions:

  • Always warm up, cool down and stretch before and after physical activity
  • Don’t rapidly increase training speed, length or intensity
  • Rest as soon as you notice Achilles tendon pain, to avoid worsening any existing problems
  • Always wear supportive, sport-specific shoes
  • Wear custom orthotics as prescribed, especially if you have flat feet or tend to pronate
  • Limit the amount of time you spend in high heels, since wearing these shoes regularly can shorten the Achilles tendon and increase your risk for tendinopathy
  • Try to reach and maintain a healthy weight

Achilles tendinopathy help in Powder Springs

Pain in your Achilles tendon won’t go away on its own. In fact, ignoring or pushing through discomfort is likely to make everything worse. Want to heal your tendon and get back to doing what you love? Reach out to our office today to request an immediate appointment.