Achilles tendonitis is a relatively common ailment that affects a broad number of people. It can be treatable with rest and proper care. Proper footwear, wearing custom orthotics, and an understanding of the causes of Achilles tendonitis can prevent this injury from occurring in the first place. Footstar Orthotics has compiled all of the information that our clients need to know about Achilles tendonitis causes, symptoms, and treatments, along with solutions for prevention through the use of our custom orthotic insoles.
What is Achilles Tendonitis?
The heel bone connects to the calf muscle at the lower back of the leg through the Achilles tendon. The Achilles is a tough band of tendons, and is the largest and strongest tendon in the body. However, it is still prone to strain and injury. The Achilles tendon is used whenever the foot is in motion, including during activities such as walking, running, and jumping. The muscles of the calf flex, which causes the Achilles tendon to pull on the heel.
Achilles tendonitis occurs when the tendon is overused and becomes inflamed. The tiny tears that form in the tendon cause it to grow and swell. When the tendon degenerates, it creates a painful condition that makes motions like walking or running difficult to perform. Achilles tendonitis is a fairly common condition, especially for runners or athletes.
Causes of Achilles Tendonitis
A number of factors may cause the development of Achilles tendonitis. Typically, this condition is not the result of an acute injury, but often develops over time with excessive exercise or a dramatic increase in the duration or frequency of training. There are also several causes of heel pain that do not involve motion, such as infection or rheumatoid arthritis, which put people at risk for this condition. Other causes of Achilles tendonitis include:
- Overuse or heavy physical activity – Overuse of the Achilles tendon occurs when an individual completes an intense level of physical activity that is a drastic increase from what they are used to. For example, a person who does not regularly run should not begin a new intense program without easing into it first. Sudden changes in exercise levels are the primary cause of Achilles tendonitis.
- Sports that require a fast start-stop motion, such as tennis or basketball – The force required to start and stop quickly leads to excessive stretching and contracting of the tendon. These types of activities can result in strain, small tears, jarring, and twisting of the heel area, all of which can contribute to Achilles tendonitis and require treatment.
- Not properly warming up before exercising – The Achilles tendon needs to be gently warmed up before beginning exercise. Without doing so, the Achilles tendon is expected to take on the stress and strain of physical activity without being properly prepared. Taking the time to warm up beforehand can make a significant difference in the way the Achilles tendon responds to physical activity, allowing it to become more malleable and become more flexible over time.
- Failure to stretch properly – Stretching is a critical part of any successful exercise or training program, it is used for preventing injuries caused by the physical demands put on muscles that are not adequately prepared. When muscles have not been stretched, they are shortened and tight, and sudden activity can lead to stress and injury. This means that the Achilles tendon is more likely to become strained and overused.
- Running or training in inflexible shoes – Footwear that is too rigid does not allow for minor adjustments in the gait and forces the Achilles tendon to twist in an unnatural way. This causes undue strain on the tendon and leads to Achilles pain and inflammation.
- Wearing unsupportive or worn out shoes – Shoes that lack proper support leave room for foot imbalances to occur. Flat feet that do not have an adequate arch build-up will roll inward. This is known as over pronation, and it causes an unnatural pulling on the Achilles tendon. Individuals with very high arches often have a gait that causes the foot to roll towards the outside edge, known as supination. When the arches are not supported by the appropriate footwear, these imbalances put unnecessary strain on the heel, ankle, and Achilles tendon, leaving the wearer vulnerable to developing tendonitis. Athletes of all fitness levels should replace their shoes on a regular basis to ensure that they remain free of injury or arch pain.
- Running on uneven surfaces or very hard ground – Surfaces such as stone or concrete are unforgiving on the joints and muscles of the body. When you run on a hard surface, it causes your feet to pound on the pavement repeatedly. This can add too much strain to the heel and the Achilles tendon, particularly when you are not wearing the proper footwear. Uneven surfaces cause imbalances in the way the foot strikes the ground, and an unstable gait can lead to Achilles tendonitis. Runners should attempt to run on artificial surfaces like turf, or on softer surfaces like grass or gravel wherever possible, to reduce their risk of injury.
- Wearing high heels for extended periods of time – When a person wears high heels, their feet remain in a “tip toe” position. Achilles tendonitis occurs when the wearer removes high heels and suddenly changes to flat shoes or bare feet. The extreme stretching that happens is traumatic for the tendon, which has been shortened and compressed for a long period and then suddenly stretched. High heels do little to support the feet or provide stability and cushioning required for optimal foot health.
- Repeated exercises that strain the calf muscles – Repetitive movements such as springing off the ground when running, or jumping while dancing, can cause tightness in the calf muscles. Without proper stretching, these muscles become shortened and will pull on the Achilles tendon, creating a chain of tight muscles that trickles down the leg and into the foot. The repetitive action of these motions will make this problem worse over time and can eventually lead to Achilles tendonitis, particularly if the body is not used to movements of this nature.
- Biomechanical issues, such as flat feet, high arches, tight calf muscles, or bone spurs – Some people are born with a predisposition to Achilles tendonitis. There are a number of pre-existing conditions that contribute to what causes heel pain, and these include various mechanical issues. This includes tight muscles in the leg, fallen arches, calcified bone spurs, and variations in the type of arches in the feet.
- Aging – Achilles tendonitis is more prevalent in older adults than in young people. Over time, the Achilles tendon becomes more rigid and less flexible, making older adults more prone to developing Achilles tendonitis.
While some of these causes are uncontrollable, others are a result of user error or overuse on the part of the individual. No matter the cause of Achilles tendonitis, the common factors that lead to this condition involve overuse and unnatural movements of the foot, which result in injury.
Symptoms of Achilles Tendonitis
The most predominant symptom of Achilles tendonitis is swelling and pain in the back of the heel. The pain may begin as a dull ache and become more pronounced and localized during exercise. Walking or running will intensify the pain and make it feel worse than it did when the body was at rest. Other symptoms of Achilles tendonitis include the following:
- The Achilles tendon feels warm to the touch – you will feel a “burning” or warm sensation at the surface of the skin. This is a known warning sign of inflammation.
- Limited range of motion in the foot – Achilles tendonitis makes several positions of the foot extremely painful, such as the movement between a flexed foot and a foot in the pointed position. When the Achilles tendon is torn or inflamed, this type of motion is very painful.
- Swelling in the back of the heel that increases with activity – As an individual exercises or uses the Achilles tendon by walking, they are aggravating the existing symptoms of their condition. They may notice more redness, warmth, and swelling around the heel and ankle after exercising.
- Bone spurs in the back of the heels – Bone spurs may begin to form as a result of a type of pain called insertional Achilles tendonitis, where the damaged tendon fibers start to calcify and form hardened heel spurs on the back of the foot.
- Tightness in the calf muscles – When the Achilles tendon becomes overworked, it can cause all of the surrounding muscles to seize up, becoming tense and rigid in response to the injury. Because the Achilles tendon is directly connected to the calf muscle, the two often mirror each other in their symptoms and injuries.
- Achilles tendon stiffness in the morning – It is common for the Achilles tendon to become stiff and tense in the morning when it hasn’t been used throughout the night. Just as muscles need to be warmed up before exercising, an injured Achilles tendon requires some gentle stretching and motion before it can be used without pain.
- Pain during physical activity – Achilles tendonitis becomes more exacerbated with physical activity and may be less pronounced at the beginning of a workout. It’s not uncommon for an individual to begin exercising with very little pain only to feel extreme pain by the end of their training session after an already aggravated Achilles tendon has been overworked.
- Pain that does not subside after physical activity has ceased – Achilles tendonitis may be worse during exercise. Symptoms can still be present when the body is at rest. When pain and discomfort in the Achilles tendon do not subside with rest, they are a sign that there is something more than muscle fatigue at play.
The pain and discomfort of Achilles tendonitis can make it difficult for individuals to carry out their normal activities on a daily basis. When an injury prevents a person from enjoying their normal range of motion, it is a problem that should be addressed quickly to maintain physical wellness and quality of life.
If you are experiencing pain and believe you are showing symptoms of Achilles tendonitis, a health care professional should be able to help. Be sure to call your local physician for an official diagnosis and further treatment options.
Risk Factors for Achilles Tendonitis
Certain activities can cause Achilles tendonitis and make the pain feel worse after the condition has developed. Athletes who engage in tennis, dance, gymnastics, or basketball, for example may experience Achilles tendonitis more frequently than people who participate in low impact sports such as cycling and swimming. Running exacerbates Achilles tendonitis because of the motion involved, as does walking for extended periods of time, especially when the body is not used to these activities.
Some individuals are more susceptible to developing Achilles tendonitis. People who have flat feet or fallen arches are more likely to experience Achilles tendonitis. Other risk factors associated with this condition include:
- Age – Achilles tendonitis is more common in older adults.
- Sex – men are more prone to getting Achilles tendonitis than women.
- Obesity – excessive weight places too much strain on the tendon.
- Tight calves – rigid muscles do not allow the tendon to stretch and move the way it’s supposed to.
- Predisposed medical conditions, including psoriasis, high blood pressure, and rheumatoid arthritis can all contribute to a higher occurrence of Achilles tendonitis.
- Training conditions – training in hilly terrain and during cold weather increases the chances of developing Achilles tendonitis.
- Women who wear high heels – when the heel does not fully extend to the ground, it becomes shortened over time and degenerates when switching to flat shoes or engaging in physical activity.
- Poorly conditioned athletes – not exercising regularly, training properly, or stretching during exercise.
How to Treat Achilles Tendonitis
Achilles tendonitis is treated in a number of ways, including rest, reducing physical activity, changing to a low impact sport, going to regular physiotherapy sessions, taking anti-inflammatory medications such as ibuprofen, wearing a brace that prevents movement in the foot, applying ice to the area, and elevation. Treatment for Achilles tendonitis will need to be repeated with every new occurrence and is often required to keep future incidents at bay.
Ongoing physical therapy can be costly and inconvenient for many people, and for some, it’s simply not available if they live in remote areas. Also, many individuals do not have the time to rest and elevate their feet, do not want the inconvenience of wearing a brace, and prefer not to take anti-inflammatory medications on a regular basis.
Treatment of Achilles tendonitis is possible, but it requires, patience, time, and personal sacrifice to achieve a full recovery. Professional athletes or individuals who are very dedicated to their sports will find it difficult to put their training on hold while recovering from Achilles tendonitis. Rest periods required will vary, but the typical recommendation is two days, which is not possible for some people whose job or lifestyle requires them to be on their feet for long periods.
How Footstar Orthotics Help Prevent Achilles Tendonitis
Rather than endure the recovery process involved with treating Achilles tendonitis, it is much more preferable to prevent the condition from occurring in the first place. Footstar Orthotics knows that prevention can be accomplished through using orthotic insoles. Over the counter orthotics may begin to provide some relief, but custom orthotics that are designed specifically with an individual’s foot in mind will yield much greater healing and treatment results.
Custom orthotics will be able to support the foot and provide the heel with the right amount of stability to lower the risk of developing Achilles tendonitis. When shoes are too loose or too stiff, orthotics will ensure that the heel receives the appropriate amount of stability for a person’s unique needs.
Orthotic insoles also provide support for the arches, preventing over pronation, which can contribute to Achilles tendonitis. When wearing orthotics with proper arch support for flat feet, the foot is prevented from rolling inward when walking or running, decreasing the chances of developing Achilles tendonitis.
Footstar’s orthotics are tailor made for each customer, meaning that the relief and prevention solutions that a client receives from our products have been adjusted to the exact specifications of their foot. There is no finer way to prioritize the health of your feet than with a pair of custom orthotics that will improve overall function while reducing the likelihood of suffering from a debilitating Achilles tendonitis injury.
How Footstar’s Orthotics Relieve Existing Achilles Tendonitis
Orthotic supports provide relief to existing cases of Achilles tendonitis as they prevent the tendon from being extended all the way. Stretching the tendon when it is already inflamed can cause more pain, meaning that a slightly raised heel will be more comfortable than a completely flat shoe. For this reason, Footstar Orthotics offers support for those who have trouble with their Achilles tendon, allowing the heel to sit in an optimal position where it is neither overextended nor shortened.
Footstar Orthotics custom inserts are designed to keep the foot in the best position possible to promote healing and foot health. Those with Achilles tendonitis will find relief in wearing their Footstar orthotics as they cradle the foot and hold it in the proper alignment and provide the ideal amount of support for each individual’s arch shape. Achilles tendonitis will heal more quickly when the foot can remain in the correct position, whether it’s in use or at rest.