- Kevin Lutta, MD, is a foot and ankle specialist and practices in our Herndon and Tysons offices.
Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel. Tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.
Noninsertional Achilles Tendinitis
In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.Tendinitis of the middle portion of the tendon more commonly affects younger, active people.
Insertional Achilles Tendinitis
Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.
In both noninsertional and insertional Achilles Tendinitis, damaged tendon fibers may also calcify (harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.
Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.
What Causes Achilles Tendinitis?
Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon.
Common symptoms of Achilles tendinitis include:
• Pain and stiffness along the Achilles tendon in the morning
• Pain along the tendon or back of the heel that worsens with activity
• Severe pain the day after exercising
• Thickening of the tendon
• Bone spur (insertional tendinitis)
• Swelling that is present all the time and gets worse throughout the day with activity
Doctor Examination:After you describe your symptoms, I would examine your foot and ankle. I would look for these signs:
• Swelling along the Achilles tendon or at the back of your heel
• Thickening or enlargement of the Achilles tendon
• Bony spurs at the lower part of the tendon at the back of your heel (insertional tendinitis)
• The point of maximum tenderness
• Pain in the middle of the tendon, (noninsertional tendinitis)
• Pain at the back of your heel at the lower part of the tendon (insertional tendinitis)
• Limited range of motion in your ankle—specifically, a decreased ability to flex your foot
Diagnostic Tests: I may order imaging tests to make sure your symptoms are caused by Achilles tendinitis.
These could include X-rays and/or Magnetic Resonance Imaging (MRI)
For more information about how to treat Achilles Tendinitis please visit www.aaos.com.
For more information on Dr. Lutta, read his bio on our website.