Achilles Tendinitis

The basics The achilles tendon connects the calf muscle to the heel bone. It is the thick cordlike structure along the back of your ankle. Achilles tendinitis commonly affects athletes whose sports involve a lot of running or jumping. Pain and inflammation occurs along the tendon and may radiate up the calf. It may hurt when you rise up on your tippy toes or when you pull your foot up towards your shin. More severe cases may involve swelling in the area or a thickened tendon. Sometimes a grating sensation can be felt (called crepitus) when your move your ankle up and down. This indicates that the sheath surrounding the tendon is also inflamed and is called tenosynovitis. Old running shoes or a flat foot can contribute to achilles tendinitis. Be sure to have your injury evaluated by your athletic trainer or doctor.

Treatment Initial treatment involves rest or reducing activity (depending on injury severity), taping, cold therapy, treatment modalities, and light stretching under the supervision of your athletic trainer or doctor. Sometimes a heel lift placed in the shoe can be helpful. While some athletes are able to continue participation with a mild case of achilles tendinitis, more severe injuries may require some downtime. Alternative conditioning exercises can be performed that don’t aggravate the injury such as the stationary bike or elliptical trainer.

Rehabilitation Once the injury starts to improve, strengthening is important, especially eccentrically. Eccentric (negative) contractions occur during the lowering or “negative” phase of a resistance exercise and are important in strengthening the tendon to withstand the loads incurred while playing sports. For example, if you are doing a calf raise off the edge of a step, the “concentric” contraction would occur when you rise up on your tippy toes as the calf muscle shortens. The “eccentric” contraction occurs when the muscle lengthens as you slowly lower your heels back to the starting position under control. It is important to perform quality eccentric contractions with your rehabilitation exercises when recovering from a case of tendinitis.