What Is Achilles Tendonitis? | UPMC Orthopaedic Care

Achilles tendon problems are very common, especially among middle-aged “weekend warriors” who don’t exercise regularly. The largest and strongest tendon in the body, the Achilles anchors the calf muscles to the heel bone- which subjects it to very high forces. When running, the Achilles tendon can pull with a force equal to many times the body weight. And, because it lacks a strong blood supply, the tendon can weaken and degrade over time, putting it at risk of a rupture.

Injury Basics of the Achilles Tendon

Achilles tendon injuries may seem to happen suddenly, but they usually result from tiny tears that happen over time. These chronic, or long-term injuries, to the tendon microstructure, often result from overuse or training. In some cases, the tendon damage goes undetected until a large force, such as a cut or jump, causes it to rupture- often with an audible “pop.” Many patients feel as if they were shot or kicked in the back of the ankle.

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Types of Achilles Tendon Injuries

The common types of Achilles tendon injuries include:

  • Achilles tendonitis is an inflamed or painful tendon.
  • Achilles tendinosis, or tendinopathy, are tiny tears (microtears) and internal degeneration of the tendon causing soreness or stiffness. It comes on gradually and continues to worsen until treated.
  • Achilles tendon rupture is tearing and separation of the tendon fibers so that the tendon can no longer function normally.

Causes of Achilles Tendon Injuries

Common causes of Achilles tendon injuries include:

  • Overuse
  • Sudden increase in the amount or intensity of physical activity
  • Wearing high heels
  • High arched or flat feet
  • Tight muscles or tendons in the leg

Achilles Tendon Injury Treatments

According to foot and ankle surgeon Stephen F. Conti, MD, early treatment works best and can prevent additional injury. Minor Achilles tendon discomfort can be treated with rest, anti-inflammatory medication, stretching, and moist heat. An orthopaedic foot and ankle specialist should treat any Achilles tendon discomfort lasting longer than a month.

Newer specialized treatments include Platelet Rich Plasma (PRP) injection therapy. Physical therapy also can be helpful.

Treatment for severe problems, such as a torn ruptured tendon, may include surgery, or a cast, splint, brace, walking boot or other devices that immobilize the lower leg. Surgery includes removing a bone spur that is hitting the Achilles tendon, repairing the tear, and removing the damaged portion and transferring the tendon to the heel bone to restore motion.

Recovery from Achilles Tendon Surgery

Patients who undergo surgery can expect to be on crutches and in a cast for six to eight weeks, followed by months of therapy. It may take up to a year to reach maximum improvement. Although it takes time, the treatment of Achilles tendon problems usually works with most people returning to sports and other activities.

About UPMC Orthopaedic Care

When you are dealing with bone, muscle, or joint pain, it can affect your daily life. UPMC Orthopaedic Care can help. As a national leader in advanced orthopaedic care, we diagnose and treat a full range of musculoskeletal disorders, from the acute and chronic to the common and complex. We provide access to UPMC’s vast network of support services for both surgical and nonsurgical treatments and a full continuum of care. Our multidisciplinary team of experts will work with you to develop the treatment plan that works best for you. Our care team uses the most innovative tools and techniques to provide better outcomes. We also are leaders in research and clinical trials, striving to find better ways to provide our patients care. With locations throughout our communities, you can find a provider near you.