Achilles Tendinitis is a common
overuse injury which results in inflammation of the achilles tendon, most frequently causing mild to severe heel pain. The achilles tendon is the largest tendon in the body, connecting your calf
muscle to your heel bone. It?s used with every step - when you walk, run, and jump. Although the Achilles tendon can withstand great stresses, it?s also prone to tendinitis. The condition is very
common in athletes, especially runners who?ve suddenly increased the intensity or duration of their workouts. It?s also common in middle-aged, ?weekend athletes? who play sports like tennis or
basketball only occasionally. The pain from achilles tendinitis may be felt anywhere from the back of the leg to the top of the heel. Most cases are mild and can be treated at home under a
podiatrist?s supervision. Severe cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
Achilles tendinitis is caused by repeated stress to the tendon, not a direct injury. Often times, this can happen from doing too much too soon and not giving your body enough time to rest or adjust
to the increase in intensity or amount of exercise. Another contributing factor can be tight calf muscles. Having tight calf muscles and starting an activity can put added stress on the achilles
In most cases, symptoms of Achilles tendonitis, also sometimes called Achilles tendinitis, develop gradually. Pain may be mild at first and worsen with continued activity. Repeated or continued
stress on the Achilles tendon increases inflammation and may cause it to rupture. Partial or complete rupture results in traumatic damage and severe pain, making walking virtually impossible and
requiring a long recovery period. Patients with tendinosis may experience a sensation of fullness in the back of the lower leg or develop a hard knot of tissue (nodule).
If you think you might have Achilles tendonitis, check in with your doctor before it gets any worse. Your doc will ask about the activities you've been doing and will examine your leg, foot, ankle,
and knee for range of motion. If your pain is more severe, the doctor may also make sure you haven't ruptured (torn) your Achilles tendon. To check this, the doc might have you lie face down and bend
your knee while he or she presses on your calf muscles to see if your foot flexes. Any flexing of the foot means the tendon is at least partly intact. It's possible that the doctor might also order
an X-ray or MRI scan of your foot and leg to check for fractures, partial tears of the tendon, or signs of a condition that might get worse. Foot and ankle pain also might be a sign of other overuse
injuries that can cause foot and heel pain, like plantar fasciitis and Sever's disease. If you also have any problems like these, they also need to be treated.
Use the R.I.C.E method of treatment when you first notice the pain. Although rest is a key part of treating tendonitis, prolonged inactivity can cause stiffness in your joints. Move the injured ankle
through its full range of motion and perform gentle calf and ankle stretches to maintain flexibility. If self-care doesn't work, it's important to get the injury treated because if the tendon
continues to sustain small tears through movement, it can rupture under excessive stress. Your doctor may suggest a temporary foot insert that elevates your heel and may relieve strain on the tendon.
Other possible treatments include special heel pads or cups to wear in your shoes to cushion and support your heel, or a splint to wear at night. Physical therapy may also help allow the tendon to
heal and repair itself over a period of weeks.
Surgery for an acute Achilles tendon tear is seemingly straightforward. The ends of the torn tendon are surgically exposed and sutures are used to tie the ends together. The sutures used to tie
together the torn tendon ends are thick and strong, and are woven into the Achilles both above and below the tear. While the concepts of surgery are straightforward, the execution is more complex.
Care must be taken to ensure the tendon is repaired with the proper tension -- not too tight or too loose. The skin must be taken care of, as excessive handling of the soft tissues can cause severe
problems including infection and skin necrosis. Nerves are located just adjacent to the tendon, and must be protected to prevent nerve injury. If surgery is decided upon, it is usually performed
within days or weeks of the injury. The idea is to perform the repair before scar tissue has formed, which would make the repair more difficult. Some surgeons may recommend delaying surgery a few
days from the initial injury to allow swelling to subside before proceeding with the repair.
Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the
following precautions. Getting a variety of exercise - alternating between high-impact exercises (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the
Achilles tendon is under less tension. Limit certain exercises - doing too much hill running, for example, can put excessive strain on the Achilles tendon. Wearing the correct shoes and replacing
them when worn - making sure they support the arch and protect the heel will create less tension in the tendon. Using arch supports inside the shoe, if the shoe is in good condition but doesn't
provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely. Stretching, doing this before and after exercising helps to keep the
Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility. Gradually
increasing the intensity of a workout - Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your
muscles time to loosen up and puts less pressure on the tendon.