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Michigan Sports and Spine

Achilles Tendonitis

Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.

Noninsertional Achilles Tendinitis
In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.  Tendinitis of the middle portion of the tendon more commonly affects younger, active people.

Insertional Achilles Tendinitis
Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone.  In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.  Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.

Repetitive stress to the tendon
Sudden increase in the amount or intensity of exercise activity
Tight calf muscles
Bone spur

Pain and stiffness along the Achilles tendon in the morning
Pain along the tendon or back of the heel that worsens with activity
Severe pain the day after exercising
Thickening of the tendon
Bone spur
Swelling that is present all the time and gets worse through the day with activity

Physical examination and medical history consultation

Non-steroidal anti-inflammatory medications
Physical therapy
Cortisone injections
Extracorporeal shockwave therapy



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