The Achilles tendon is a major muscle group that originates in the back of the leg and attaches to the back of the heel bone. The tendons major function is to lift the heel during walking. Overuse of this muscle group can cause inflammation to the tissues surrounding the tendon.

The term overuse does refer to excessive use of this muscle group which could be experienced in any strenuous activity including work out conditions. Tight calve muscles can increase the amount of stress to the tendon during normal walking and in conjunction with overuse can lead to the greater risk of injury. People who are physically de-conditioned experience this condition more frequently.

The “itis” in Achilles Tendonitis refers to an inflammatory process involving the tendon prior to its attachment site. The “watershed” region of the Achilles tendon about three inches above its attachment has limited blood flow and is generally the site of injury. There are different stages of injury to the tendon tissues: Para tendonitis involves the acute inflammation of the vascular lining over the Achilles tendon and is characterized by acute pain to massage and manipulation of the tissues overlying the Watershed region. Tendinosis is characterized by a nodule in the watershed region of injury related to chronic inflammation and scarring of the tendon.

Treatment is aimed at reducing the biomechanical stresses acting on the Achilles tendon as well as decreasing inflammation in the area of injury. For acute inflammation a walking cast (CAM boot) may be required to rest the tendon. Shoes with a heel are one of the most important ways to rest the tendon during normal walking. Heel lifts placed in the shoe also decrease some of the mechanical tendon work during recovery.

Additional treatments including, calf stretching, night splints, physical therapy as well as activity modification are all important contributors in recovery.