Overview
Achilles tendonitis (tendinitis), is a painful and often debilitating inflammation of the Achilles tendon than can progress into degeneration which we call Achilles Tendinosis. The Achilles tendon is the largest and strongest tendon in the body. It is located in the back of the lower leg, attaches to the heel bone (calcaneus), and connects the calf muscles to the heel bone. In most cases, Achilles tendonopathy’s are overuse injuries are more common among athletes and people who train heavily, however it can also occur in people who are less active. Achilles Tendonitis can vary in severity from a mild pain in the tendon during a particular activity to more severe cases when any form of activity that puts strain on this ligament, even standing or walking, can cause pain.
Causes
Achilles tendinitis is caused by repetitive or intense strain on the Achilles tendon, the band of tissue that connects your calf muscles to your heel bone. This tendon is used when you walk, run, jump or push up on your toes. The structure of the Achilles tendon weakens with age, which can make it more susceptible to injury – particularly in people who may participate in sports only on the weekends or who have suddenly increased the intensity of their running programs.
Symptoms
Symptoms of Achilles tendinitis and tendinosis include recurring localized heel pain, sometimes severe, along the achilles tendon during or after exercise. Pain often begins after exercise and gradually worsens. Morning tenderness or stiffness about an inch and a half above the point where the Achilles tendon is attached to the heel bone. Sluggishness in your leg. Mild to severe swelling. Stiffness that generally diminishes as the tendon warms up with use.
Diagnosis
The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further studies are necessary.
Nonsurgical Treatment
Treatment for achilles tendonitis is based around initially reducing pain and inflammation, stretching the muscles out and a gradual return to activity. No one single approach may cure achilles tendonitis, particularly a chronic condition but a combination of treatment approaches and patience will work best. It is essential the correct treatment is started as soon as possible in the acute stage to avoid the injury becoming chronic. Acute achilles tendonitis requires rest. Continuing to train on a painful achilles tendon could lead to the injury becoming chronic and more difficult to treat. Applying ice or cold therapy as soon as possible to a painful achilles tendon will reduce pain and inflammation. After the first 24 to 48 hours alternating hot and cold or just heat may be more beneficial. Tendons work better when they are warm but if they are painful then rest and ice. Wear a heel pad to raise the heel and shorten the calf muscles which in turn reduces some of the strain on the achilles tendon. This should only be a temporary measure while the achilles tendon is healing. An achilles tendon taping technique can aid rest by supporting the tendon with elastic bandages. This is an excellent way of taking the load off the tendon if you have to walk around on your feet as well as protecting the tendon when returning to full fitness. Achilles tendon exercisesMake sure you have the right running shoes for your foot type and the sport. If you are a runner that over-pronates then a motion control or support running shoe may be needed. Visit a specialist running shop for advice. In the later stages apply heat, especially before exercise. The tendon will perform better when warm. Finish with cold after training to reduce any inflammation.
Surgical Treatment
There are two types of Achilles repair surgery for tendonitis (inflammation of the Achilles Tendon), if nonsurgical treatments aren’t effective. Gastrocnemius recession – The orthopaedic surgeon lengthens the calf muscles to reduce stress on your Achilles tendon. D?bridement and repair – During this procedure, the surgeon removes the damaged part of the Achilles tendon and repairs the remaining tendon with sutures or stitches. Debridement is done when the tendon has less than 50% damage.
Prevention
By properly training the body, an athlete can build the strength of their tendons and muscles. Following a workout and dieting plan, the body will be able to build muscle and strengthen most effectively. Additionally, doing the following can prevent tendinitis. Wearing appropriate shoes will give your foot the support it needs for proper movements of the foot and ankle. Improper movements will put additional stress on your body. Stretching before an athletic activity, Stretching primes the body for a taxing activity. Additionally, this will get your blood flowing and reduce the risk of pulling a muscle. Ask your doctor about orthotics, Custom orthotics can help get your foot into proper alignment. If the foot does not execute proper mechanics, the body will adjust which will cause pain and increase the chances of injury.
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