tendinitis is an overuse injury of the Achilles (uh-KIL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. Under too much stress, the tendon
tightens and is forced to work too hard. This causes it to become inflamed (that?s Achilles tendinitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon.
If the inflamed Achilles continues to be stressed, it can tear or rupture. Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs.
It?s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends. Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under
your doctor?s supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require
Achilles tendinitis usually results from overuse and not a specific injury or trauma. When the body is subject to repetitive stress, the Achilles tendon is more prone to become inflamed. Other
factors may cause Achilles tendinitis, such as, Sudden increase in physical activity, which can be related to distance, speed or hills, without giving yourself adequate time to adjust to the
heightened activity. With running up hills, the Achilles tendon has to stretch more for each stride, which creates rapid fatigue. Inadequate footwear or training surface. High heels may cause a
problem, because the Achilles tendon and calf muscles are shortened. While exercising in flat, athletic shoes, the tendon is then stretched beyond its normal range, putting abnormal strain on the
tendon. Tight calf muscles which gives the foot a decreased range of motion. The strained calf muscles may also put extra strain on the Achilles tendon. Bone spur where the Achilles tendon attaches
to the heel bone, aggravating the tendon and causing pain.
Common symptoms of Achilles tendinitis include, pain and stiffness along the Achilles tendon in the morning, pain along the tendon or back of the heel that worsens with activity, Severe pain the day
after exercising, thickening of the tendon, bone spur (insertional tendinitis) swelling that is present all the time and gets worse throughout the day with activity, If you have experienced a sudden
"pop" in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.
During an examination of the foot and ankle, you doctor will look for the following signs, Achilles tendon swelling or thickening. Bone spurs appearing at the lower part of the tendon at the back of
the hell. Pain at the middle or lower area of the Achilles tendon. Limited range of motion of the foot and ankle, and a decreased ability to flex the foot. Your doctor may perform imaging tests, such
as X-rays and MRI scans, to make a diagnosis of Achilles tendinitis. X-rays show images of the bones and can help the physician to determine if the Achilles tendon has become hardened, which
indicated insertional Achilles tendinitis. MRI scans may not be necessary, but they are important guides if you are recommended to have surgical treatment. An MRI can show the severity of the damage
and determine what kind of procedure would be best to address the condition.
The best treatment for Achilles tendonitis is preventative, stretching and warming up properly before starting an activity. Proper rest, accompanied by stretching and icing to reduce swelling, can
help to heal an overworked Achilles tendon. Placing an adequate heel lift in both shoes will allow the heel to have contact with the ground without placing stress on the Achilles tendon. Wear a tie
shoe that is stiff soled and has a wide base, then add an over-the-counter or custom foot orthosis inside the shoe to prevent the twisting motion of the Achilles tendon due to over pronation. In the
event that the tendon is unable to heal due to your life style or activity, you may have to be put in a walking cast for a short period to give it a chance to heal. You need to have the doctor,
physical therapist, or come in to our facility to check for a leg length difference due to the walking cast being higher. This is to prevent any discomfort to the hips. After the tendon has healed
and before the foot is taken out of the walking cast, range of motion at the ankle must be tested and if the foot is not allowed to properly bend upwards 15 degrees then the tightness in the calf
will cause the foot to over pronate and reinjure. A stretching program will be needed to loosen up the calf muscle before much weight bearing is done without the cast. The stretching program can be
found at the menu for feet hurt. If necessary a heel lift can be put in both shoes to help take the stress off the tendon. Should the tightness of the calves be the primary cause for the Achilles
tendon damage and stretching has not loosen the Achilles tendon sufficiently, then discussion with your doctor for a calf release may have to be considered.
If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon.
As with all injuries, prevention is your best defense especially with injuries that are as painful and inconvenient as Achilles tendonitis. Options for how to prevent Achilles tendonitis include,
stretching- Stretching properly, starting slowly, and increasing gradually will be critical if you want to avoid Achilles tendonitis. To help maintain flexibility in the ankle joint, begin each day
with a series of stretches and be certain to stretch prior to, and after, any exercise or excessive physical activity. Orthotics and Heel Support- Bio-mechanically engineered inserts and heel cups
can be placed in your shoes to correct misalignments or bolster the support of your foot and are available without a prescription. The temporary heel padding that these provide reduces the length
that the Achilles tendon stretches each time you step, making it more comfortable to go about your daily routine. Proper Footwear- Low-heeled shoes with good arch support and shock absorption are
best for the health of your foot. Look into heel wedges and other shoe inserts to make sure that your everyday foot mechanics are operating under ideal conditions.