Achilles tendonitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone.
Achilles tendonitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It’s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends.
The main difference between Achilles tendonitis and Achilles tendinosis is time. Achilles tendinosis is a chronic (persistent or recurring) condition caused by repetitive trauma or an injury that hasn’t healed. By contrast, Achilles tendonitis is an acute (sudden, short-term) condition in which inflammation is caused by a direct injury to a tendon. The differences are reflected in their suffixes, with “-osis” meaning abnormal or diseased and “-itis” meaning inflammation.
Achilles tendonitis treatments usually begins with relatively simple, at-home care under your doctor’s supervision. Self-care strategies are usually necessary to prevent recurring episodes. Other treatments may include physical therapy, stretching, orthotic devices, and steroid injections. If those conservative treatments have failed or it appears to be Achilles tendinosis, you are faced with surgery to debride/scrape the damaged tissue from the Achilles tendon or a single treatment of Orthowave® High-energy Shockwave Therapy, the FDA approved non-invasive alternative to surgery.
Achilles tendonitis pain normally begins as a mild ache just above the heal after running or other athletic activities. It may become more frequent and painful, occurring during routine activities like walking or climbing stairs. You may notice the Achilles is tender and stiff in the morning which may improve with some activity.
Where your Achilles Tendonitis hurts can vary from the heel to the calf, although it is commonly felt where the Achilles inserts (attaches) to the calcaneus (heal bone). The most obvious symptom of Achilles tendonitis is pain that often worsens with moderate to strenuous activity.
Your mild to moderate Achilles tendonitis can heal on its own and there are several things you can do to help. Rest, rest your leg and avoid putting weight on it. Ice, apply ice to the Achilles for up to 20 minutes at a time. Compress, use a bandage or wrap around your Achilles to reduce the swelling. Elevate, prop your leg up when you are sitting or lying down. Nonsteroidal anti-inflammatory drugs (NSAIDs) can help with your swelling and pain. Follow the instructions on the label and call your doctor if you need them more than 7 to 10 days. Finally, stretching and strengthening exercises recommended by a qualified healthcare provider will help with healing.
It may take weeks or months depending on the seriousness of the Achilles tendonitis. You can often remain active as it heals but pushing it too hard runs the risk of making it worse and long lasting (tendinosis). You need to give your body time to heal before easing back into your old level of activity. If it hurts, you are pushing it too hard.
If your Achilles tendonitis goes untreated, it can lead to tendinosis or a possible rupture. A series of tears form, weakening the tendon. As you “play through the pain,” those tears are filled in with scar tissue that provides no tensile strength and inhibits healing. Chronic Achilles tendonitis, called tendinosis, can be treated surgically with a debridement or non-invasively with High-energy Extracorporeal Shockwave Therapy.