Achilles tendinitis is caused by overuse associated with exercise or excessive walking, which leads to pressure and inflammation affecting either the tendon itself or the point at which the Achilles tendon attaches to the bone.

Causes

1. Running every day, walking briskly, or increasing the intensity and distance too much at a time while exercising, thus not giving the tendons sufficient time to adapt.
2. Not conducting a warm up and cool down before and after exercise respectively.
3. Sports that involve a jump stop or rapid changes of direction, such as badminton or tennis.
4. Regularly jumping from height.
5. Walking in high-heeled shoes for prolonged periods or footwear that does not provide enough support to the sole.
6. Age-related degeneration of tendon tissue or degeneration resulting from continuous and prolonged overuse.

Risk Factors

1. Aging and gender, with males more at risk than females
2. Certain congenital conditions, such as gout, leprosy, and high blood pressure
3. Flat footedness, overpronation, shortening of the Achilles tendon, and obesity
4. Certain types of drugs such as fluoroquinolones or prolonged use of steroid medication
5. Improper running technique, frequently running up and down hills, or unusually cold weather

Symptoms

The condition tends to start out as a mild ache at the back of the heel or an acute swelling and redness that can seem unbearable. The pain is usually worse when walking and improves when resting. Chronic cases can lead to a torn Achilles tendon, as can an intense strain caused by excessive weight being placed through the heel.
 

Treatment

1. Using a cool compress to treat acute redness and swelling, while rest, ice and elevation are also recommended.
2. Walking in a way that spreads the weight throughout the foot instead of placing greater pressure through the heel, which will place strain on the tendon.
3. Reducing any standing or walking as much as possible until there is no pain present when taking the first steps each morning.
4. Courses of medication and shockwave therapy.
5. Surgery may be considered in chronic cases whereby the condition is significantly affecting the patient’s daily life, and where a tear has been identified during screening. Hence, it is vital that patients seek medical attention at the outset as this will increase their chances of making a full recovery, while also reducing the likelihood of the condition making a comeback at a later date.

 
Written by Dr. Withoon Boonthanomwong, Orthopedic Surgeon at the Orthopedics Center, Bumrungrad International Hospital