Everything You Need To Know Concerning Achilles Tendonitis

Overview

Achilles TendonThe Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel. Virtually all of the force generated when you ?toe off? the ground during running is transmitted by the Achilles, and this force can be as much as three times your body weight. And the faster you run, the more strain you put on the Achilles tendon. As such, it?s prone to injury in many runners, but particularly those who do a lot of fast training, uphill running, or use a forefoot-striking style. Achilles tendon injuries account for 5-12% of all running injuries, and occur disproportionately in men. This may be because of the faster absolute speeds men tend to train at, or may be due to other biomechanical factors.




Causes

Achilles tendinitis can be caused by overly tight calf muscles, excessive running up hill or down hill, a sudden increase in the amount of exercise, e.g. running for a longer distance, wearing ill-fitting running shoes, such as those with soles that are too stiff, or wearing high heels regularly, or changing between high heels all day and flat shoes or low running shoes in the evening. Overuse is common in walkers, runners, dancers and other athletes who do a lot of jumping and sudden starts/stops, which exert a lot of stress on the Achilles tendon. Continuing to stress an inflamed Achilles tendon can cause rupture of the tendon - it snaps, often with a distinctive popping sound. A ruptured Achilles tendon makes it virtually impossible to walk. An Achilles tendon rupture is usually treated by surgical repair or wearing a cast.




Symptoms

The pain associated with Achilles tendonitis can come on gradually or be caused by some type of leg or foot trauma. The pain can be a shooting, burning, or a dull ache. You can experience the pain at either the insertion point on the back of the heel or upwards on the Achilles tendon within a few inches. Swelling is also common along the area with the pain. The onset of discomfort at the insertion can cause a bump to occur called a Haglund's deformities or Pump bump. This can be inflammation in the bursa sac that surrounds the insertion of the Achilles tendon, scar tissue from continuous tares of the tendon, or even some calcium buildup. In this situation the wearing of closed back shoes could irritate the bump. In the event of a rupture, which is rare, the foot will not be able to go through the final stage of push off causing instability. Finally, you may experience discomfort, even cramping in the calf muscle.




Diagnosis

Physicians usually pinch your Achilles tendon with their fingers to test for swelling and pain. If the tendon itself is inflamed, your physician may be able to feel warmth and swelling around the tissue, or, in chronic cases, lumps of scar tissue. You will probably be asked to walk around the exam room so your physician can examine your stride. To check for complete rupture of the tendon, your physician may perform the Thompson test. Your physician squeezes your calf; if your Achilles is not torn, the foot will point downward. If your Achilles is torn, the foot will remain in the same position. Should your physician require a closer look, these imaging tests may be performed. X-rays taken from different angles may be used to rule out other problems, such as ankle fractures. MRI (magnetic resonance imaging) uses magnetic waves to create pictures of your ankle that let physicians more clearly look at the tendons surrounding your ankle joint.




Nonsurgical Treatment

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.

Achilles Tendon




Surgical Treatment

Surgery for an Achilles tendon rupture can be done with a single large incision, which is called open surgery. Or it can be done with several small incisions. This is called percutaneous surgery. The differences in age and activity levels of people who get surgery can make it hard to know if Achilles tendon surgery is effective. The success of your surgery can depend on, your surgeon's experience. The type of surgery you have. How damaged the tendon is. How soon after rupture the surgery is done. How soon you start your rehab program after surgery. How well you follow your rehab program. Talk to your surgeon about his or her surgical experience. Ask about his or her success rate with the technique that would best treat your condition.




Prevention

Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain 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.

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