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.