Achilles Tendon Anatomy
- A fibrous band of tissue that connects the two calf muscles to the heel.
- The Achilles tendon is the largest and strongest tendon in the body.
- Achilles tendinitis is the most common overuse injury in the lower leg, accounting for 5-18% of the total number of running injuries.
What Does the Achilles Tendon Do?
- Since the Achilles tendon attaches your calf to your foot, your Achilles plays an important role in every functional activity that involves pushing your foot off the ground i.e. walking, running, stairs, etc.
- It is sometimes called the calcaneal tendon because of its attachment on the heel bone (calcaneous).
- It pulls on the heel bone allowing a person to raise onto their toes or forcibly push off the ground.
How Do Achilles Injuries Occur?
- Overpronated foot
- High arches
- Calf tightness
- Inappropriate training variables
- Overtraining and fatigue
- Muscular insufficiency
- Shoe type during training
- Sacroiliac dysfunction or poor pelvic stability
- Foot and ankle will be in external rotation (turned out) with walking.
- Certain types of antibiotics, called fluoroquinolones, have been associated with higher rates of Achilles tendinitis.
- Use of corticosteroids has also been associated with increased risk of Achilles tendinitis.
Achilles Tendinitis
- Insertional:
- A degeneration of the fibers of the Achilles tendon directly at its insertion to the heel bone. Pain will occur at this site.
- Bone spurs often form with insertional Achilles tendinitis.
- Noninsertional:
- Can also be called peritendinitis.
- The inflammation is limited to the tendon, and thickening can occur.
- Pain is normally about 2-3 cm above its insertion at the heel bone.
- Tendinitis of the middle portion of the tendon more commonly affects younger, active people.
Symptoms of Achilles Tendinitis
- Gradual onset of pain and swelling in achilles tendon or at its insertion
- Pain and stiffness in achilles tendon right away in the morning
- Pain in achilles tendon at start of activity
- Not uncommon for symptoms to improve as the activity progresses.
- In more advanced stages, there will be pain in tendon at rest.
Differential Diagnosis
- Retrocalcaneal bursitis
- Metabolic diseases
- Arthritis
- Chondropathic disease on ankle joint
- Os trigonum
- Heel contusion
- Plantar heel pain
- Fracture or stress fracture
Achilles Tendon Specialists In The Twin Cities
If you are experiencing any symptoms of Achilles Tendinitis please contact us today to set up your appointment with a Minnesota physical therapist. We have physical therapy clinics located in Minneapolis and Edina.