Achilles tendinitis is a common problem that will cause pain with walking and running over the Achilles tendon on the posterior portion of the ankle. We think there are several different reasons why this can develop for patients. One of the common problems we see is having too much tightness of the Achilles tendon and the muscles above the Achilles tendon called the gastrocnemius and soleus.
Achilles tendinitis occurs when the Achilles tendon gets inflamed, and it will cause pain and typically swelling over the area. The first line treatment for this is using ice and anti-inflammatories and then doing specific eccentric stretching exercises. An eccentric Achilles tendon stretch is best performed when you stand with the ball the foot on a stair and hang your heel off the back of a stair and let the heel drop down as far as it can. It is important to do the stretch with the knee straight and extended, because if you bend the knee when you do the stretch, you are only stretching the soleus portion of the muscle but not the gastrocnemius.
We think after Achilles tendons have been inflamed for about 6 months the inflammation phase starts to convert to a more degenerative phase were people get Achilles tendinosis. Achilles tendinosis is when the tendon itself starts to degenerate and become less strong than it typically should be. People who have Achilles tendinosis are more prone to get Achilles tendon ruptures with activity.
If you have Achilles tendinitis or Achilles tendinosis and the conservative treatments at home have not worked, sometimes using a higher dose anti-inflammatory and immobilizing your foot and ankle in a Cam walker type boot can be helpful to rest the tendon and try to let it heal. Stem cell type injections can also be done for this to try and help the healing process.
If this does not work, surgical debridement and repair of the tendon can also be performed, and sometimes we also perform a flexor hallucis longus tendon transfer. This tendon works similarly to the Achilles tendon to try to maintain strength of the Achilles tendon, but helps the Achilles tendon not have to work quite so hard.
If you are suffering from Achilles tendinitis or any other foot and ankle problems, call your Colorado Springs foot and ankle surgeons today at 719-488-4664.
