An inflamed Achilles tendon, often called Achilles tendonitis, affects the strong band of tissue connecting the calf muscles to the heel bone. This common issue arises when the tendon experiences overuse or a sudden increase in physical activity, placing repetitive stress on the tissue. Symptoms typically include pain and stiffness in the back of the leg, just above the heel, which may worsen with activity or be more noticeable in the morning. While it can affect anyone, it is frequently observed in runners and individuals participating in sports involving sudden stops and starts.
Immediate Self-Care Measures
Immediate self-care measures can help manage pain and reduce inflammation. The R.I.C.E. protocol (Rest, Ice, Compression, and Elevation) is a recommended first step. Resting the tendon means avoiding activities that aggravate pain, allowing the tissue to heal. This might involve switching to low-impact activities like swimming or cycling.
Applying ice for 15 to 20 minutes every few hours helps control swelling and numb pain. Wrap ice in a towel to avoid direct skin contact. Compression, using an elastic bandage, provides support and reduces swelling. Elevating the foot above heart level also assists in reducing swelling and pressure on the tendon.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can alleviate pain and inflammation. These medications should be used for the shortest duration necessary. Individuals with certain health conditions should consult a doctor before use.
When to Seek Professional Help
While self-care measures provide initial relief, professional medical evaluation is sometimes necessary. Seek prompt medical attention if pain persists or worsens despite home treatment, swelling increases, you have difficulty bearing weight, restricted range of motion, or cannot stand on tiptoes.
A sudden, sharp pain in the back of the ankle, sometimes with a popping or snapping sensation, could signal an Achilles tendon rupture. Seek immediate medical help to prevent further damage and ensure effective recovery. Delayed treatment can increase the risk of long-term complications.
A healthcare provider will perform a physical examination, assessing for tenderness, swelling, or gaps in the tendon. They may also inquire about symptoms and recent activities. Imaging tests, such as ultrasound or MRI, might be used to determine the injury’s extent. Based on the diagnosis, a doctor might recommend physical therapy, stronger medication, or injections. Corticosteroid injections offer rapid pain relief but are used sparingly due to potential tendon risks.
Rehabilitation and Strengthening Exercises
A structured exercise program is important for long-term recovery and preventing re-injury. These exercises improve flexibility, strengthen calf muscles, and enhance the tendon’s ability to tolerate load. Consulting a physical therapist is often recommended to develop a personalized plan.
Eccentric heel drops are an effective exercise for Achilles tendon rehabilitation. Stand on a step with the balls of your feet at the edge. Rise onto your toes using both feet, then slowly lower the heel of the injured leg below the step level. The movement should be slow and controlled, emphasizing the lengthening phase of the calf muscles. The Alfredson protocol suggests performing three sets of 15 eccentric heel drops, twice daily, for 12 weeks, with both straight and bent knees to target different calf muscles.
Calf stretches also improve flexibility and reduce tension in the Achilles tendon. A common stretch involves placing one foot behind the other against a wall, keeping the back leg straight and heel on the ground. Lean forward until a stretch is felt in the calf. Another variation involves bending the back knee to target different calf muscles. Hold these stretches for 15-30 seconds and repeat several times daily, without causing pain.
Other strengthening exercises, such as seated calf raises and single-leg balance exercises, support recovery by strengthening calf muscles and improving ankle stability. Gradually increase intensity and repetitions, listening to your body to avoid overexertion. These exercises build tendon resilience and reduce future inflammation.
Preventing Recurrence
Preventing Achilles tendon inflammation involves long-term strategies for tendon health. Gradually increase physical activity, especially when starting new routines or increasing intensity. The “10% rule” suggests increasing activity by no more than 10% per week to allow adaptation.
Proper warm-up and cool-down routines are also important. Warming up with light exercises prepares muscles and tendons for activity. Cooling down with stretches helps maintain flexibility and reduce muscle tightness. Regular calf muscle stretching, before and after exercise, helps prevent excessive strain on the Achilles tendon.
Wearing appropriate footwear is another factor in preventing recurrence. Shoes should provide adequate arch support, cushioning, and stability to reduce tendon stress. A shoe with a moderate heel-to-toe drop can help reduce strain by decreasing tension during activity. Avoid shoes that are too stiff or lack proper support. Custom orthotics or heel lifts might be recommended to address specific foot biomechanics.
Addressing underlying biomechanical issues, such as overpronation, also contributes to prevention. Weak calf muscles or poor ankle flexibility increase stress on the Achilles tendon, making strengthening and flexibility exercises important. Incorporating cross-training activities, like swimming or cycling, reduces repetitive stress while maintaining overall fitness.