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.
The causes of Achilles tendonitis all appear to be related to excessive stress being transmitted through the tendon. Weak calf muscles, poor ankle range of motion, and excessive pronation have all
been connected with the development of Achilles problems.The upshot is that all of these factors, plus training volume and so on, result in damage to the tendon. Much like a bungee cord is made up of
tiny strands of rubber aligned together, tendons are comprised of small fiber-like proteins called collagen. Pain in the Achilles tendon is a result of damage to the collagen. Because of this,
treatment options should start with ways to address this.
Patients with this condition typically experience pain in the region of the heel and back of the ankle. In less severe cases, patients may only experience an ache or stiffness in the Achilles region
that increases with rest (typically at night or first thing in the morning) following activities which place stress on the Achilles tendon. These activities typically include walking or running
excessively (especially uphill or on uneven surfaces), jumping, hopping, performing heel raises or performing calf stretches. The pain associated with this condition may also warm up with activity in
the initial stages of injury. As the condition progresses, patients may experience symptoms that increase during sport or activity, affecting performance. Pain may also increase when performing a
calf stretch or heel raise (i.e. rising up onto tip toes). In severe cases, patients may walk with a limp or be unable to weight bear on the affected leg. Patients with Achilles tendonitis may also
experience swelling, tenderness on firmly touching the Achilles tendon, weakness and sometimes palpable thickening of the affected Achilles tendon when compared with the unaffected side.
To diagnose the condition correctly, your doctor will ask you a few questions about the pain and swelling in your heel. You may be asked to stand on the balls of your feet while your doctor observes
your range of motion and flexibility. The doctor may also touch the area directly. This allows him to pinpoint where the pain and swelling is most severe.
To help heal your Achille?s Tendinitis, follow the R.I.C.E. Principle including Rest, Ice Compression and Elevation. In addition your physiotherapist will likely recommend specific exercises promote
healing and strengthening of the Achilles tendon and its supporting structures. As well an orthotic that elevates your heel can reduce stress on your Achilles tendon. Reducing inflammation in the
tendon is important too this can often be achieved with oral pills or topical creams. Over-the-counter pain medications or prescription strength such as ibuprofen. However, these drugs can have side
effects, like an increased risk of bleeding ulcers. They should be used only occasionally unless your doctor specifically says otherwise. Topical anti-inflammatory creams made with natural
ingredients designed specifically for feet and legs (eg ZAX?s Original Heelspur Cream ) target the affected areas and provides effective and safe relief. Tendinitis usually responds well to self-care
measures. But if your signs and symptoms are severe or persistent, your doctor might suggest other treatment options including surgery.
Surgery is considered the last resort and is often performed by an orthopedic surgeon. It is only recommended if all other treatment options have failed after at least six months. In this situation,
badly damaged portions of the tendon may be removed. If the tendon has ruptured, surgery is necessary to re-attach the tendon. Rehabilitation, including stretching and strength exercises, is started
soon after the surgery. In most cases, normal activities can be resumed after about 10 weeks. Return to competitive sport for some people may be delayed for about three to six months.
Stay in good shape year-round and try to keep your muscles as strong as they can be. Strong, flexible muscles work more efficiently and put less stress on your tendon. Increase the intensity and
length of your exercise sessions gradually. This is especially important if you've been inactive for a while or you're new to a sport. Always warm up before you go for a run or play a sport. If your
muscles are tight, your Achilles tendons have to work harder to compensate. Stretch it out. Stretch your legs, especially your calves, hamstrings, quadriceps, and thigh muscles - these muscles help
stabilize your knee while running. Get shoes that fit properly and are designed for your sport. If you're a jogger, go to a running specialty store and have a trained professional help you select
shoes that match your foot type and offer plenty of support. Replace your shoes before they become worn out. Try to run on softer surfaces like grass, dirt trails, or synthetic tracks. Hard surfaces
like concrete or asphalt can put extra pressure on the joints. Also avoid running up or down hills as much as possible. Vary your exercise routine. Work different muscle groups to keep yourself in
good overall shape and keep individual muscles from getting overused. If you notice any symptoms of Achilles tendonitis, stop running or doing activities that put stress on your feet. Wait until all
the pain is gone or you have been cleared to start participating again by a doctor.