Chronic heel pain when walking, running, or doing activities may be at risk of “Achilles tendinitis,” which is commonly found in athletes or those who frequently use their ankles repeatedly. Importantly, these symptoms often hinder daily life because foot movement becomes difficult.
How to treat Achilles tendinitis? Know the causes, symptoms, and prevention and treatment guidelines to reduce risk
Table of Contents Achilles Tendinitis
- What are the symptoms of Achilles tendinitis?
- What causes Achilles tendinitis?
- How to diagnose Achilles tendinitis symptoms
- How many treatment methods are there for Achilles tendinitis? What are they?
- Non-surgical treatment for Achilles tendinitis
- Surgical treatment for Achilles tendinitis
- What are the advantages of surgical treatment for Achilles tendinitis?
- Does surgery cure Achilles tendinitis completely?
- Is untreated Achilles tendinitis dangerous?
- How many days to recover after Achilles tendinitis surgery? How to take care of yourself?
- How to prevent Achilles tendinitis
What are the symptoms of Achilles tendinitis?
Achilles tendinitis (Achilles Tendinosis) is a type of tendon pain (Overuse Injury) caused by accumulation and does not occur suddenly. Common symptoms include:
- Pain, burning sensation in the Achilles tendon area during use
- Swelling around the ankle
- Chronic heel pain, pain when stepping, walking, or running
- Difficulty moving the ankle, such as bending or stretching the foot
- In chronic stages, calcium deposits may accumulate, feeling like a lump on the Achilles tendon
These symptoms affect walking, running, or performing various activities.
Note: The Achilles tendon is the tendon located at the back of the calf. It is the largest and strongest tendon, acting like a spring that tightens to help absorb shock when we move, stand up, walk, run, or jump.
What causes Achilles tendinitis?
- Excessive ankle use, such as standing for long periods, walking a lot, or repetitive exercise causing strain and injury
- Over-exercising, especially long-distance running, sports involving acceleration and deceleration, or frequent jumping
- Wearing inappropriate shoes or worn-out shoes
- Unsuitable surfaces for running, walking, or exercising
- Being overweight, putting excessive pressure on the ankle
- Ankle injuries such as fractures, cracks, or impact injuries
- Chronic diseases such as arthritis, diabetes, or rheumatoid arthritis
How to diagnose Achilles tendinitis symptoms
If symptoms suggest Achilles tendon inflammation, diagnostic methods include:
- Taking medical history and initial physical examination
- X-Ray or MRI to identify abnormalities in the tendon and surrounding tissues
How many treatment methods are there for Achilles tendinitis? What are they?
Treatment for Achilles tendinitis can be divided into two main methods: non-surgical and surgical treatment.
Non-surgical treatment for Achilles tendinitis
- Rest the foot by reducing excessive strain on the ankle
- Apply cold compresses to the ankle to reduce swelling and pain
- Take anti-inflammatory and pain relief medications such as NSAIDs
- Wear supportive sports shoes or use ankle braces to support the ankle during movement
- Physical therapy massage to relax muscles around the ankle and improve blood circulation
- Shockwave therapy
If non-surgical treatment is ineffective, the doctor may consider surgical treatment.
Surgical treatment for Achilles tendinitis
Surgical treatment varies depending on severity, such as partial removal of the inflamed Achilles tendon, surgery to reduce tendon tension by adjusting bone alignment, or reconstructive surgery for severely damaged tendons.
Currently, there are two surgical techniques: open repair surgery and minimally invasive repair surgery.
1. Open repair surgery for Achilles tendon
This is a conventional surgery involving an open incision to expose the tendon. The doctor then repairs the tendon to strengthen it. The incision is about 10-15 centimeters, considered a large wound, requiring a relatively long recovery time.
2. Minimally invasive Achilles tendon repair surgery
This is an arthroscopic surgery, currently very popular because the incisions are small, causing less pain and faster recovery. Patients can recover quickly, reducing pain and surgical complications. The surgery leaves about 6 to 7 small holes, each about 8-10 mm in size.
What are the advantages of surgical treatment for Achilles tendinitis?
Surgical treatment for Achilles tendinitis is a good option, with an effectiveness of about 80-90% for complete recovery.
Advantages of surgical treatment for Achilles tendinitis
- Directly addresses the root cause, eliminating pain and swelling, allowing full ankle function
- Lower chance of recurrence compared to other treatments
However, patients must rest after surgery and undergo regular physical therapy to prevent joint stiffness and restore strength to muscles and tendons around the ankle.
Does Achilles tendinitis surgery cure completely?
Generally, after surgery, patients can fully use their ankle and perform activities within about 3-6 months, depending on the severity before surgery and proper post-operative rehabilitation.
Is untreated Achilles tendinitis dangerous?
With Achilles tendinitis, patients cannot use their ankle normally and often experience pain during use. If ignored and the condition persists, the tendon gradually degenerates, leading to tendon rupture, causing severe pain and inability to walk.
How many days to recover after Achilles tendinitis surgery? How to take care of yourself?
After Achilles tendon surgery, swelling of the joint and surrounding tissues occurs, requiring recovery time for the tendon to heal properly, averaging 6 weeks to 3 months, depending on the surgical method.
Self-care methods
3-8 weeks after surgery: The doctor will advise avoiding weight-bearing on the foot during this period, then monitor progress and gradually allow partial weight-bearing with crutches.
8-12 weeks after surgery: The doctor may allow normal shoe wearing and full weight-bearing, but running or heavy sports should still be avoided.
Athletes may need additional physical therapy to strengthen muscles and tendons.
How to prevent Achilles tendinitis
Although Achilles tendinitis can be completely cured, prevention is better than treatment. Therefore, follow these guidelines:
- Exercise appropriately to increase flexibility of the body and ankles
- Avoid excessive ankle strain in a short period
- Wear soft, cushioned sports shoes with good ankle support
- Choose suitable exercise surfaces, such as flexible treadmills or paths with minimal impact
- Maintain a normal body weight to avoid excessive pressure on the ankles
- If swelling or soreness occurs after exercise, rest the foot and apply cold compresses. Do not overexert or push through the pain
Following these recommendations helps reduce the risk of Achilles tendinitis and prevents long-term ankle injuries.
Dr. Chakorn Rimchala
Orthopedic Surgery, Foot and Ankle Surgery
Bone and Joint Center, Phyathai 3 Hospital
