Achilles Tendonitis
Overview
Achilles tendinitis. Achilles tendonitis is inflammation of the Achilles tendon, the largest tendon in the body, which runs from the calf to the heel bone. Noninsertional Achilles tendonitis affects fibers in the middle of the tendon. Insertional Achilles tendonitis affects the lower portion of the tendon where it attaches to the heel bone. Both types can result from repetitive stress to the tendon or from overstressing the tendon during exercise. Damaged tendon fibers can calcify and bone spurs can form where the tendon attaches to the bone. Symptoms may include pain and stiffness of the tendon - which may occur from either inactivity (such as first thing in the morning) or after activity - thickening or swelling of the tendon or bone spurs.
Causes
The two most common causes of Achilles tendonitis are Lack of flexibility and Overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.
Symptoms
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.
Diagnosis
The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further studies are necessary.
Nonsurgical Treatment
Treatment will depend on the severity of the injury. In general terms, the longer the symptoms are present before treatment begins, the longer the timeframe until complete recovery is achieved. Complete recovery can take between three and nine months. Initial treatment of Achilles tendonitis includes, Rest, to avoid further injury to the area. Ice, to reduce inflammation, Elevation, to reduce swelling. Bandaging or strapping, to support the area and restrict movement of the tendon. Anti-inflammatory medications to reduce pain and inflammation. (Cortisone (steroid) injections to reduce inflammation are not usually recommended as they may weaken the tendon and increase the risk of rupture). Other treatments include, Physiotherapy, Physiotherapy plays an important role in the treatment of Achilles tendonitis. This generally focuses on two main areas - treatment and rehabilitation. Treatment may involve such techniques as massage, ultrasound, acupuncture and gentle stretching. Rehabilitation involves the development of an individualised recovery programme, the most important aspect of which is strengthening. Strengthening of the muscles surrounding the Achilles tendon helps to promote healing in the tendon itself. Strengthening is achieved through the use of specific exercises, which will be taught by the physiotherapist. One such exercise is eccentric loading, which involves contracting the calf muscle while it is being stretched. It is common for the rehabilitation programme to take up to three months. Podiatry, including gait analysis and the fitting of orthotic devices to support the foot and reduce stress on the tendon, may be recommended. For cases of Achilles tendonitis that do not respond to initial treatment, casting or splinting of the affected foot may be recommended to allow it to rest completely.
Surgical Treatment
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.
Prevention
You can take measures to reduce your risk of developing Achilles Tendinitis. This includes, Increasing your activity level gradually, choosing your shoes carefully, daily stretching and doing exercises to strengthen your calf muscles. As well, applying a small amount ZAX?s Original Heelspur Cream onto your Achilles tendon before and after exercise.
Achilles tendinitis. Achilles tendonitis is inflammation of the Achilles tendon, the largest tendon in the body, which runs from the calf to the heel bone. Noninsertional Achilles tendonitis affects fibers in the middle of the tendon. Insertional Achilles tendonitis affects the lower portion of the tendon where it attaches to the heel bone. Both types can result from repetitive stress to the tendon or from overstressing the tendon during exercise. Damaged tendon fibers can calcify and bone spurs can form where the tendon attaches to the bone. Symptoms may include pain and stiffness of the tendon - which may occur from either inactivity (such as first thing in the morning) or after activity - thickening or swelling of the tendon or bone spurs.
Causes
The two most common causes of Achilles tendonitis are Lack of flexibility and Overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.
Symptoms
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.
Diagnosis
The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further studies are necessary.
Nonsurgical Treatment
Treatment will depend on the severity of the injury. In general terms, the longer the symptoms are present before treatment begins, the longer the timeframe until complete recovery is achieved. Complete recovery can take between three and nine months. Initial treatment of Achilles tendonitis includes, Rest, to avoid further injury to the area. Ice, to reduce inflammation, Elevation, to reduce swelling. Bandaging or strapping, to support the area and restrict movement of the tendon. Anti-inflammatory medications to reduce pain and inflammation. (Cortisone (steroid) injections to reduce inflammation are not usually recommended as they may weaken the tendon and increase the risk of rupture). Other treatments include, Physiotherapy, Physiotherapy plays an important role in the treatment of Achilles tendonitis. This generally focuses on two main areas - treatment and rehabilitation. Treatment may involve such techniques as massage, ultrasound, acupuncture and gentle stretching. Rehabilitation involves the development of an individualised recovery programme, the most important aspect of which is strengthening. Strengthening of the muscles surrounding the Achilles tendon helps to promote healing in the tendon itself. Strengthening is achieved through the use of specific exercises, which will be taught by the physiotherapist. One such exercise is eccentric loading, which involves contracting the calf muscle while it is being stretched. It is common for the rehabilitation programme to take up to three months. Podiatry, including gait analysis and the fitting of orthotic devices to support the foot and reduce stress on the tendon, may be recommended. For cases of Achilles tendonitis that do not respond to initial treatment, casting or splinting of the affected foot may be recommended to allow it to rest completely.
Surgical Treatment
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.
Prevention
You can take measures to reduce your risk of developing Achilles Tendinitis. This includes, Increasing your activity level gradually, choosing your shoes carefully, daily stretching and doing exercises to strengthen your calf muscles. As well, applying a small amount ZAX?s Original Heelspur Cream onto your Achilles tendon before and after exercise.
