What is achilles tendonitis? How does it occur?

The Achilles tendon is a tough, elastic tissue that sits on the back of the foot, behind the ankle. It is the largest and strongest tendon in the body, which allows us to stand on our toes and point our toes towards the ground. 

It is a fundamental tendon whose primary function is focused on plantar flexion of the ankle, thus promoting walking, running, and jumping.

However, when the Achilles tendon is subjected to repetitive and intense strain or stress, a widespread inflammation or injury occurs, known as Achilles tendinitis. 

This injury usually affects athletes who exert pressure on the heel due to biomechanical alterations of the foot, such as excessive pronation or supination or even shortening of the calves.

Achilles tendonitis prognosis

In most cases, Achilles tendinitis is usually not severe and does not typically have long-lasting consequences. However, there are cases in which Achilles tendinitis can weaken the tendon and can degenerate into a rupture, which requires surgical intervention. In other cases, symptoms may persist, causing constant joint stiffness.

What are the symptoms of Achilles tendonitis?

The main symptom of Achilles tendonitis is pain above the heel and in the lower leg, especially after physical activity. 

• Stiffness and pain in the heel, especially in the morning or after periods of prolonged rest.
• Swelling or knots in the Achilles tendon
• crunches
• leg weakness
• Tendon tenderness
• Pain through pressure exerted by shoes

Medical tests to diagnose Achilles tendonitis

To diagnose Achilles tendonitis, the patient must undergo a series of imaging tests, such as ultrasound or magnetic resonance imaging.

What causes Achilles tendonitis?

Achilles tendonitis is an injury that occurs due to repetitive overuse of the Achilles tendon. It can also take place due to different reasons:

• Increased physical exercise
• Not warming up before exercising
• Exercising in worn-out sneakers
• Not stretching after physical activity
• Having a direct blow to the tendon

Can Achilles tendonitis be prevented?

It can be prevented by following a series of guidelines to prevent Achilles tendinitis :

• keep in good shape
• maintain a feed
• Perform warm-ups before physical exercise and stretch after activity
• Wear suitable shoes for sports
• Running on soft surfaces
• Perform different types of exercise
• muscle stretches

Achilles tendonitis treatment

Treatment to correct Achilles tendonitis begins with a break from the activity that led to the injury. Otherwise, the tendon may be further damaged. For this reason, proper treatment should include:

• Stretching the Achilles tendon and muscles for 30 seconds three or four times a day
• Cold application on the heel every 2 hours for 15 minutes
• Intake of anti-inflammatories
• Use of custom orthopedic insoles
• Application of soft padding if the tendon rubs against the surface of the shoe, in the case of Haglund’s disease
• Application of percutaneous intertissued electrolysis (EPI)
• Infiltrations with biological therapies such as PRP or Orthokine

This is the usual treatment for Achilles tendonitis. However, in some cases, the patient must undergo surgery because the symptoms do not disappear after following the steps of the previous treatment.

Types of surgery for Achilles tendonitis

• Conventional surgery, in which 5-6 centimeter incisions are made
• endoscopic surgery
• Ultrasound-guided surgery, 1-2 millimeter incision