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The achilles tendon is the largest and strongest tendon in the body and is made up of two muscles: the gastrocnemius and the soleus. Tightness in the achilles tendon (called equinus) can lead to pathology usually manifesting as pain in the tendon about 2-6cm above its insertion into the back of the heel (Non-insertional Achilles tendinitis) or at the insertion itself (Insertional Achilles tendinitis).  Sudden increases in the intensity or amount of exercises can also lead to pain in the achilles tendon.

  • Common symptoms of Achilles tendinitis include:

  • Pain in the achilles tendon with the first few steps in the morning

  • Pain with increased activity

  • Thickening of the tendon which you can feel  approx. 2-6 cm above the insertion

  • Bone spur on the back of the heel which you can sometimes feel if it is large

  • Swelling and pain which worsen throughout the day

Treating Achilles tendinitis

Treatment depends on severity. Most patients have already tried some kind of home therapy including anti-inflammatory medications, ice, rest, stretching etc. In some mild cases of achilles tendinitis these treatments may be sufficient, but in many cases they are not. A physician may treat achilles tendinitis with heel lifts, orthotics, adaptive shoe gear, a below knee cast or walker, NSAIDs, Medrol Dose Pak, Physical Therapy, etc. The average recovery time is 3-6 months.

If conservative care fails surgical treatment may be an option. For insertional achilles tendinitis this usually involves removal of the heel spur, debridement of the achilles (removal of diseased portions), with or without lengthening of the achilles (gastrocnemius recession). To remove the heel spurs, the achilles must be partially or completely released from its insertion into the calcaneus (heel bone).  Following this release, strong anchors are placed in the bone to reattach the achilles. Following surgery, a period of non-weight bearing is required which is usually anywhere from 4-8 weeks.  Sometimes physical therapy is required as part of the recovery process.  Statistically, achilles tendon repairs have a high success rate and are a good alternative to living in pain.

If you are suffering from achilles tendon pain, consider scheduling an appointment at Texas Foot and Ankle Specialists. We are conveniently located adjacent to the La Centerra outdoor shopping center across from Cinco Ranch High School in the Katy area of west Houston. We have convenient hours to accommodate a variety of schedules and offer same day appointments for those with pressing needs.