The gastrocnemius and soleus complex (calf muscles) share a common tendon called the Achilles tendon. The Achilles tendon attaches to the calcaneous (heel). Achilles tendonitis is an inflammation of the tendon that may eventually lead to areas of tissue degeneration and possibly microtears or even a tear.

Achilles tendonitis is one of the most common overuse injuries. There is a high incidence in runners, particularly long distance runners, ballet dancers, skaters, soccer players and basketball players. Overuse usually occurs when the demands put on the muscle and its tendons exceed its strength and flexibility.

Overuse of the gastroc-soleus complex causes microtears of the Achilles tendon and as a result the tendon becomes inflamed.

• Most often comes on gradually.
• Often starts as stiffness in the back of the heel after a long run.
• Without alteration in training, the stiffness becomes pain that may persist through and after the run.
• Pain with walking stairs.
• Pain may be present at rest in advanced cases.
• May have stiffness in the morning.
• Tendon may feel thick and swollen.
• Tendon may be painful to touch.

In many cases there are many contributing factors that may cause Achilles tendonitis.

• An improper warm-up.
• A sudden increase in duration, intensity, frequency of the workout.
• Running on the side of the road (slight incline).
• Running on uneven surfaces.

• Muscle imbalance, such as imbalance between gastroc-soleus strength and Achilles tendon.
• Age changes in the tendon.
• Flat feet cause increased stress on Achilles tendon.

• Flat feet
• Increased internal rotation of the femur. This could be caused by a weak gluteus medius muscle.
• External rotation of the tibia.

• Worn out shoes.
• Loose fitting heel in the shoe.

• Direct injury to Achilles tendon.

Appropriate treatment for Achilles tendonitis will include:

• Ice for 10 – 15 minutes 4 – 5 times per day.
• Calf stretches.
• Avoid aggravating activities.
• Wear proper footwear.