Matthew D. Neuhaus, DPM
300 Stonecrest Blvd. Suite 350
Smyrna, TN 37167
(615) 220-8788
Located on the 3rd Floor of the Physician Office Building at StoneCrest Medical Center

What is the Achilles Tendon?

A tendon is a band of tissue that connects a muscle to a bone. The Achilles tendon is the largest tendon in the human body and can withstand forces of 1,000 pounds or more. But it also the most frequently ruptured tendon. The Achilles tendon runs down the back of the lower leg and connects the calf muscle to the heel bone. The Achilles tendon facilitates walking by helping to raise the heel off the ground.

What causes Achilles Tendonitis and how is Achilles Tendonitis diagnosed?

Achilles Tendonitis is usually caused by a sudden increase of repetitive activity involving the Achilles tendon. This type of activity puts too much stress on the tendon, leading to the micro-injury of the tendon fibers. Continual stress on the tendon prevents the body from repairing the injured tissue. Ultimately, the tendon structure is altered causing continual pain. Athletes are not the only individuals that are at high risk for developing this disorder.

The disorder is also common for individuals whose work puts stress on their feet and ankles such as laborers or ones who participate in athletics on the weekend or infrequently. In addition, people with excessive flattening of the arch have a greater tendency to develop this disorder due to greater demands placed on the Achilles tendon while walking.If proper shoes with correct stability is not worn for these individuals, this could further aggravate the Achilles tendon.

Achilles is diagnosed after evaluating range of motion and the condition of the ankle. The extent of the diagnoses could be further evaluated with X-Rays, Ultrasound, and MRI.

Events that can cause Achilles tendonitis may include:

Hill running or stair climbing.
Overuse resulting from the natural lack of flexibility in the calf muscles.
Rapidly increasing mileage or speed.
Starting up too quickly after a layoff.
Trauma caused by sudden and/or hard contraction of the calf muscles when putting out extra effort such as in a final sprint.

Achilles tendonitis often begins with mild pain after exercise or running that gradually worsens. Other symptoms include:

Recurring localized pain, sometimes severe, described as aching, stiffness, soreness, or tenderness anywhere along the tendon. The pain could be anywhere from directly above the heel up to the region just below the calf muscle.
Morning tenderness or stiffness which usually subsides once activity increases throughout the day. However, the tenderness will more than likely return or worsen once one returns back to rest.
Sluggishness in your leg that decreases throughout the day or once movement has increased.
Mild or severe swelling anywhere along the tendon.

How can Achilles Tendonitis be prevented?

The best way to prevent Achilles Tendonitis from occurring or reoccurring is to strengthen and stretch the calf muscles through daily exercises. Also, wearing proper shoes with correct supports to help with stability of the feet and ankles. These shoes should be shoes appropriate for the activities one is performing.

Treatment normally includes:

Immobilization of the tendon involving the use of a cast or a removable walking boot is specifically designed to restrict motion of the tendon. This helps reduce the pressure on the tendon and repair any damage thus far.
Any oral Non-steroidal anti-inflammatory medication (NSAIDs) such as ibuprofen may be helpful in reducing pain and inflammation.
Orthoses, which are devices to help support the muscle and relieve stress on the tendon such as a heel pad or shoe insert. Custom made inserts may be prescribed by the doctor to help with the healing process of the tendon and to correct the alignment and stability of the ankle.
Rest and switching to another exercise, such as swimming, that does not stress the tendon. Also the use of ice to help with inflammation for periods of 20 minutes each morning. However, do NOT put the ice directly against the skin. Instead cover the ice with a thin towel.
Stretching, massage, ultrasound, re-education, and appropriate exercises to strengthen the weak muscle group in front of the leg and the upward foot flexors. The physician may order physical therapy for someone with Achilles Tendonitis to help reduce the pain and to help strengthen the tendon with various stretching exercises. Also, some basic stretching exercises may be done at home to help reduce the pain. Watch the basic stretching exercises video by Dr. Neuhaus or view the basic stretching exercises handout.

**NOTE: Treatment for Achilles Tendonitis is based upon how long an individual's injury has been present and the degree of damage to the tendon. In extreme cases, surgery is performed to remove the fibrous tissue and repair any tears.

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“I wrote this book because too many people suffer from foot
and ankle pain unnecessarily.”
-Dr. Matthew Neuhaus