Pain in the back of the ankle can sometimes result from injury or inflammation of the achilles tendon. Sometimes it is painful to touch, swollen, and difficult to walk on. There are many treatment options to help with recovery and avoid additional injury. If you are experiencing pain along your achilles tendon, please call our office for an appointment as we want to carefully evaluate your ankle and help improve your pain and function.
Achilles tendinopathy/tendinitis
Since the achilles tendon is the largest tendon in the body, whether you’re very active or inactive, it is likely you will experience achilles tendon pain at some point.
Risk factors for achilles tendinopathy include cold weather training, poor running mechanics, increasing age, inappropriate footwear, and medication like oral prednisone (steroid).
Though it is talked about frequently, and from time to time we see individuals with achilles tendon pain after taking fluoroquinolone antibiotics, they are rarely associated with achilles tendinopathy.
The achilles tendon is formed by two calf muscles and travels down the back of the lower leg to attach to the posterior ankle at the calcaneus. Sometimes pain is at the attachment point (insertion) and sometimes it is a couple inches above the insertion area
Recurrent microtrauma is thought to create degenerative changes to the tendon and result in tendon thickening and impaired ability to heal itself. Commonly swelling along the insertion of the achilles tendon on the back area of the heel is due to a combination of calcification (spur) and thickening of the achilles tendon. This can cause a lot of pain in the morning when you wake up and step out of bed and in the evening after hours of standing and walking.
A careful history and physical exam by a sports medicine doctor is important to adequately assess the ankle and achilles tendon looking for areas of tendinopathy, calcifications, and even bursitis near the achilles tendon insertion. Additionally, at Sports Health Northwest, we utilize ultrasound imaging to assess the achilles tendon for signs of damage.
Treatment for achilles tendinopathy involves resting from painful activity, achilles supports, rehabilitative exercises, and there are injection options and percutaneous tenotomy treatments that can provide lasting relief and minimal downtime when compared to traditional surgery.
