Typically an overuse injury, Achilles tendinitis affects the connective tissue between the calf and the heel. When you walk, run or otherwise use your leg to push your body upward, the Achilles tendon is engaged. Using the tendon frequently and with high intensity often results in tendinitis -- a swollen Achilles tendon that makes it difficult and sometimes painful to continue high-impact activities.
The two most common causes of Achilles tendonitis are Lack of flexibility and Overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.
Mild ache in the back of the lower leg, especially after running. More acute pain may occur after prolonged activity, Tenderness or stiffness in the morning. In most cases the pain associated with Achilles tendinitis is more annoying than debilitating, making sufferers regret activity after the fact, but not keeping them from doing it. More severe pain around the Achilles tendon may be a symptom of a much more serious ruptured tendon.
Studies such as x-rays and MRIs are not usually needed to make the diagnosis of tendonitis. While they are not needed for diagnosis of tendonitis, x-rays may be performed to ensure there is no other problem, such as a fracture, that could be causing the symptoms of pain and swelling. X-rays may show evidence of swelling around the tendon. MRIs are also good tests identify swelling, and will show evidence of tendonitis. However, these tests are not usually needed to confirm the diagnosis; MRIs are usually only performed if there is a suspicion of another problem that could be causing the symptoms. Once the diagnosis of tendonitis is confirmed, the next step is to proceed with appropriate treatment. Treatment depends on the specific type of tendonitis. Once the specific diagnosis is confirmed, the appropriate treatment of tendonitis can be initiated.
As with all conditions, your Doctor should be consulted. Even minor symptoms can represent significant damage to the Achilles tendon. It is recommended that medical advice be sought as soon as symptoms are experienced. Applying ice to the injury on a regular basis can reduce inflammation associated with Achilles Tendonosis. Following the initial injury, ice should be applied for periods of 15 minutes every hour. Resting the injured ankle may be necessary. This can be a problem for athletes who need to train regularly. The degree of rest required depends on the severity and type of Achilles Tendonosis. Your Health Care Professional will advise you about what activities should be limited while the injury is repairing. Fast uphill and downhill running is not advised while an Achilles Tendinosis injury is healing. Anti-inflammatory, analgesic medications such as those containing aspirin may help control pain and inflammation. Self-massage with heat-inducing creams and liniments may be of assistance. Wearing heel-lifts or pads in shoes can reduce the tension in the Achilles tendon. Physiotherapy may assist in the repair of a damaged Achilles tendon. Physiotherapists may recommend exercises to strengthen the tendon to reduce the chances of future injury. Regular stretching of the hamstring muscles (at the back of the calf) can help the repair process. This should only be done when the injury has repaired enough not to cause pain during this stretching. Taping the ankle and wearing appropriate running shoes may help to control movement in the ankle and prevent further injury.
Chronic Achilles tendon tears can be more complicated to repair. A tendon that has torn and retracted (pulled back) into the leg will scar in the shortened position over time. Restoring normal tendon length is usually not an issue when surgery is performed within a few weeks of the injury. However, when there has been a delay of months or longer, the treatment can be more complicated. Several procedures can be used to add length to a chronic Achilles tear. A turndown procedure uses tissue folded down from the top of the calf to add length to the Achilles tendon. Tendon transfers from other tendons of the ankle can also be performed to help restore function of the Achilles. The results of surgery in a chronic situation are seldom as good as an acute repair. However, in some patients, these procedures can help restore function of a chronically damaged Achilles.
Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining an adequate level of fitness for your sport. Avoid dramatic increases in sports training. If you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse. Wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses. Avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury. Maintain a normal healthy weight.