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With all the 5K races, soccer leagues, and hockey teams available, Albertans have many opportunities to get active and stay in shape. With increased activity comes an increased risk for injury—Achilles tendinitis is a common one. Understanding what the condition is and how to prevent and treat it can help you make wise activity choices and keep you in the game.

What Is Achilles Tendinitis?

Any word that ends in “itis” implies that there is inflammation, but the Achilles tissue itself doesn’t have enough blood supply to become inflamed. Injuries to the tendon actually can take several directions.

In young people, tendon problems can start with an aching, burning discomfort during activity. It may get better after a few minutes and then even worse the longer you play or run. This usually indicates an inflammation in the sheath around the tendon and is correctly called paratenonitis. The tissue will feel tender and possibly swollen at the back of the ankle, a few inches above where it is attached to the heel bone. The condition is progressive, meaning that less activity is needed each time to start the pain.

Inflamed Achilles TendonitisIn older people, the problem is more likely tendinosis. This is a degeneration of the tissue of the tendon itself, brought on by repetitive use or aging. These cause the tendon to stretch or develop tiny tears, resulting in that aching pain at the back of your ankle. If the pain is very severe and you have trouble standing on your toes or pushing off for a step, the tendon may have torn completely. Your activity may be severely limited until you get treatment and your tendon heals.

Treating Achilles Tendinitis

Whenever you feel pain behind your ankle above your heel bone, you should set up an appointment to have it examined. We will look at your ankle while you are sitting still and in motion, talk about your activity history, and palpitate the area to see what causes the pain. An MRI is very helpful to determine the appearance of the tendon sheath, or if the tendon itself has degenerated, but we can usually diagnose the problem with a physical examination.

Conservative treatments will be tried initially. These could include resting from the activity that causes pain, icing, immobilizing the area, stretching, contrast (hot/cold) baths, or anti-inflammatory medications. If this does not address the problem in a few months, other treatments such as physical therapy, bracing, casting, arch supports to correct imbalances in the foot, laser therapy, platelet-rich plasma, or extracorporeal shockwave therapies will be tried. Surgery is reserved for cases that do not heal after several conservative treatments have been tried.

Have Patience, or Better Yet, Be Preventive

Full recovery can take a year or more, so you need to be patient and let your body heal before jumping back into risky activities. No one wants to spend that much time healing from an injury, so here are some things you can do to prevent Achilles tendinitis from occurring in the first place:

  • Stretch your calf muscles at the beginning of each day and after exercise
  • Set small goals when trying a new fitness routine; make gradual increases
  • Alternate with lower-impact activities like swimming or biking
  • Wear supportive shoes that are not worn down
  • Avoid wearing high heels for long periods of time every day

At Axis Foot & Ankle Clinic we want to help you achieve and maintain good foot health. At the first sign of Achilles problems, give Dr. Andrew Irvine a call at (403) 477-3338 and schedule an appointment at our Pacific Place, Scenic Acres, or Deer Valley Medical Clinic. 

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