The Achilles tendon camera.gif connects the calf muscle to the heel bone. It lets you rise up on your toes and push off when you walk or run. The two main problems are, Achilles tendinopathy. This includes one of two conditions, Tendinitis. This actually means "inflammation of the tendon." But inflammation is rarely the cause of tendon pain. Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon. These tears are caused by overuse. In most cases, Achilles tendon pain is the result of tendinosis, not tendinitis. Some experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury. Problems with the Achilles tendon may seem to happen suddenly. But usually they are the result of many tiny tears in the tendon that have happened over time. Achilles tendinopathy is likely to occur in men older than 30. Most Achilles tendon ruptures occur in people 30 to 50 years old who are recreational athletes ("weekend warriors"). Ruptures can also happen in older adults.
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.
Signs and symptoms of Achilles Tendinitis generally include pain and stiffness along your achilles tendon, especially in the morning. Pain in the back of your heel that gets worse with activity. Severe pain the day after exercising. Swelling that gets worse with activity. If you feel a pop in the back of your heel or bottom of you calf, you may have ruptured or torn you achilles 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.
Around 1 in 4 people who have persisting pain due to Achilles tendinopathy has surgery to treat the condition. Most people have a good result from surgery and their pain is relieved. Surgery involves either of the following, removing nodules or adhesions (parts of the fibres of the tendon that have stuck together) that have developed within the damaged tendon. Making a lengthways cut in the tendon to help to stimulate and encourage tendon healing. Complications from surgery are not common but, if they do occur, can include problems with wound healing.
Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.