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.
There are two large muscles in the calf. These muscles are important for walking. They create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these
muscles to the heel. Heel pain is most often due to overuse of the foot. Rarely it is caused by an injury. Tendinitis due to overuse is most common in younger people. It can occur in walkers,
runners, or other athletes. Achilles tendinitis may be more likely to occur if you Suddenly increase the amount or intensity of an activity. Your calf muscles are very tight (not stretched out). You
run on hard surfaces such as concrete. You run too often, you jump a lot (such as when playing basketball), you do not have shoes with proper support, your foot suddenly turns in or out. Tendinitis
from arthritis is more common in middle-aged and elderly people. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and cause pain and swelling.
The main complaint associated with Achilles tendonitis is pain behind the heel. The pain is often most prominent in an area about 2-4 centimeters above where the tendon attaches to the heel. In this
location, called the watershed zone of the tendon, the blood supply to the tendon makes this area particularly susceptible. Patients with Achilles tendonitis usually experience the most significant
pain after periods of inactivity. Therefore patients tend to experience pain after first walking in the morning and when getting up after sitting for long periods of time. Patients will also
experience pain while participating in activities, such as when running or jumping. Achilles tendonitis pain associated with exercise is most significant when pushing off or jumping.
To confirm the diagnosis and consider what might be causing the problem, it?s important to see your doctor or a physiotherapist. Methods used to make a diagnosis may include, medical history,
including your exercise habits and footwear, physical examination, especially examining for thickness and tenderness of the Achilles tendon, tests that may include an x-ray of the foot, ultrasound
and occasionally blood tests (to test for an inflammatory condition), and an MRI scan of the tendon.
Achilles tendinitis can typically be treated at home by following the R.I.C.E. treatment method. Rest. Rest the tendon by avoiding activities that irritate the tendon or increase swelling. However,
this does not mean you should be completely inactive for long periods of time, as this can cause stiffness in your joints. It?s still important to stretch in order to maintain strength and
flexibility and partake in activities that don?t put direct pressure on the tendon, such as bicycling. Ice. Apply ice to the affected area for 20-minutes at a time, every couple hours, as needed, to
reduce swelling and pain. Compression. Use compression bandages to help reduce swelling. Elevation. Elevate your ankle above the level of your heart to help reduce swelling. It is particularly
important to do this at night while you sleep. Simply place a pillow or two under your ankle to keep it elevated. Once the tendon has healed, be sure to gradually return to more strenuous activities.
If flattened arches contributed to the injury, wear shoes with appropriate support or inserts to prevent the condition from progressing or recurring. If these non-surgical treatments have not been
able to provide relief of symptoms after several months, surgery may be performed to remove inflamed tissue. However, this is not usually recommended unless all other options have been exhausted.
Consult your doctor for more information about surgical treatment options.
Your doctor may recommend surgery if, after around six months, other treatments haven?t worked and your symptoms are having an impact on your day-to-day life. Surgery involves removing damaged areas
of your tendon and repairing them.
To lower your risk of Achilles tendonitis, stretch your calf muscles. Stretching at the beginning of each day will improve your agility and make you less prone to injury. You should also try to
stretch both before and after workouts. To stretch your Achilles, stand with a straight leg, and lean forward as you keep your heel on the ground. If this is painful, be sure to check with a doctor.
It is always a good idea to talk to your doctor before starting a new exercise routine. Whenever you begin a new fitness regimen, it is a good idea to set incremental goals. Gradually intensifying
your physical activity is less likely to cause injury. Limiting sudden movements that jolt the heels and calves also helps to reduce the risk of Achilles tendonitis. Try combining both high- and
low-impact exercises in your workouts to reduce stress on the tendon. For example, playing basketball can be combined with swimming. It doesn?t matter if you?re walking, running, or just hanging out.
To decrease pressure on your calves and Achilles tendon, it?s important to always wear the right shoes. That means choosing shoes with proper cushioning and arch support. If you?ve worn a pair of
shoes for a long time, consider replacing them or using arch supports. Some women feel pain in the Achilles tendon when switching from high heels to flats. Daily wearing of high heels can both
tighten and shorten the Achilles tendon. Wearing flats causes additional bending in the foot. This can be painful for the high-heel wearer who is not accustomed to the resulting flexion. One
effective strategy is to reduce the heel size of shoes gradually. This allows the tendon to slowly stretch and increase its range of motion.