Achilles Tendinitis is a
common overuse injury which results in inflammation of the achilles tendon, most frequently causing mild to severe heel pain. The achilles tendon is the largest tendon in the body, connecting your
calf muscle to your heel bone. It?s used with every step - when you walk, run, and jump. Although the Achilles tendon can withstand great stresses, it?s also prone to tendinitis. The condition is
very common in athletes, especially runners who?ve suddenly increased the intensity or duration of their workouts. It?s also common in middle-aged, ?weekend athletes? who play sports like tennis or
basketball only occasionally. The pain from achilles tendinitis may be felt anywhere from the back of the leg to the top of the heel. Most cases are mild and can be treated at home under a
podiatrist?s supervision. Severe cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
Tendinitis can result from an injury or over-use. Improper stretching prior to exertion or incorrect form during physical activity can also contribute to the development of tendinitis. Some people,
including those with ?flat feet,? tight tendons or arthritis, are particularly prone to tendinitis.
Symptoms of Achilles tendonitis include, pain in the back of the heel, difficulty walking, sometimes the pain makes walking impossible, swelling, tenderness and warmth of the Achilles tendon.
Achilles tendonitis is graded according to how severe it is, mild - pain in the Achilles tendon during a particular activity (such as running) or shortly after. Moderate - the Achilles tendon may
swell. In some cases, a hard lump (nodule) may form in the tendon. Severe - any type of activity that involves weight bearing causes pain of the Achilles tendon. Very occasionally, the Achilles
tendon may rupture (tear). When an Achilles tendon ruptures, it is said to feel like a hard whack on the heel.
During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range
of motion and reflexes of your foot and ankle. Your doctor may order one or more of the following tests to assess your condition, X-rays. While X-rays can't visualize soft tissues such as tendons,
they may help rule out other conditions that can cause similar symptoms. Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images
of the Achilles tendon in motion. Magnetic resonance imaging (MRI). Using radio waves and a very strong magnet, MRI machines can produce very detailed images of the Achilles tendon.
Proper footwear with a strong and secure counter (the heel circumference) may help to encourage heeling of the tendon. A tendinitis will occasionally resolve on it?s own, with rest, ice, and gentle
stretching. If symptoms persist for more than 2 weeks, consult your physician. Your physician may suggest physiotherapy and custom orthotics. Physiotherapy can suggest appropriate exercises and
modalities to aid in the healing process. Custom orthotics can be very successful in treating the problem, as the original cause may be due to an improper alignment of the foot and heel. Re-aligning
the foot to a neutral position may provide an optimal, biomechanically sound environment for healing to occur.
The type of surgery you will have depends on the type of injury you are faced with. The longer you have waited to have surgery will also be a factor that determines what type of surgery is needed.
With acute (recent) tearing the separation in your Achilles tendon is likely to be very minimal. If you have an acute tear you may qualify for less invasive surgery (such as a mini-open procedure).
Surgeons will always choose a shorter, less invasive procedure if it is possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the tendon and a much quicker
rate of recovery after the surgery.
Stretching of the gastrocnemius (keep knee straight) and soleus (keep knee bent) muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 - 3 times per day. Remember to stretch
well before running strengthening of foot and calf muscles (eg, heel raises) correct shoes, specifically motion-control shoes and orthotics to correct overpronation. Gradual progression of training
programme. Avoid excessive hill training. Incorporate rest into training programme.