What Leads To Achilles Tendinitis Painfulness ?

Overview

Achilles TendonitisAchilles 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 surgical repair.

Causes

The majority of Achilles tendon injuries are due to overuse injuries. Other factors that lead to Achilles tendonitis are improper shoe selection, inadequate stretching prior to engaging in athletics, a short Achilles tendon, direct trauma (injury) to the tendon, training errors and heel bone deformity. There is significant evidence that people with feet that role in excessively (over-pronate) are at greater risk for developing Achilles tendinitis. The increased pronation puts additional stress on the tendon, therefore, placing it at greater risk for injury.

Symptoms

The most common site of Achilles Tendonitis is at the heel to 4 inches above the heel. The diagnosis of this problem is made when the following signs are present. Pain in the Achilles tendon with up and down movement of the foot at the ankle. Pain in the Achilles tendon when you squeeze the tendon from side to side. If you are unable to move the foot either up or down, or you have intense pain when trying to walk, you may have a tear of the Achilles tendon, and you should see a doctor immediately. Also if you have severe pain in the calf, with or without discolorations of the skin, you may have a blood clot, and this is a medical emergency; see a doctor immediately. If you do not fall into either of these categories then try the following suggestions.

Diagnosis

If you think you have Achilles tendinitis, make an appointment to see your doctor. The doctor will ask you questions about your recent activity and look for signs. The foot not flexing when the calf muscle is pressed ( if Achilles ruptures or tears in half). Swelling on the back of the foot. Pain in the back of the foot. Limited range of motion in ankle. An X-ray or MRI scan can check for tendinitis.

Nonsurgical Treatment

Physical therapy is the first and most useful defense for achilles tendonitis because of the two presentations outlined above. Treatments for the two types are quite different in approach. Midsubstance tendinitis responds well to stretching, whereas insertional tendnitis tends to be aggravated more by it. Depend on your trusted physical therapist to differentiate between the two and follow their guidelines on exercises and running modifications. Running gait patterns that show excessive ?sinking postures? tend to point to the source of achilles tendon problems. Altering your gait in the midstance phase of the cycle can reduce the load on the tendon dramatically and thereby reduce pain. Rely on your running physical therapist for proper guidance on altering your gait the right way. Stride Strong?s Portland Running Clinic gait analysis can identify and fix potential issues before pain sets in. Icing at the onset of acute achilles pain (i.e. when the injury is fresh and new) would help control the inflammation. Your next step should be to call our number for an appointment.

Achilles Tendon

Surgical Treatment

There are two types of Achilles repair surgery for tendonitis (inflammation of the Achilles Tendon), if nonsurgical treatments aren't effective. Gastrocnemius recession - The orthopaedic surgeon lengthens the calf muscles to reduce stress on your Achilles tendon. D?bridement and repair - During this procedure, the surgeon removes the damaged part of the Achilles tendon and repairs the remaining tendon with sutures or stitches. Debridement is done when the tendon has less than 50% damage.

Prevention

Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the following precautions. Getting a variety of exercise - alternating between high-impact exercises (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the Achilles tendon is under less tension. Limit certain exercises - doing too much hill running, for example, can put excessive strain on the Achilles tendon. Wearing the correct shoes and replacing them when worn - making sure they support the arch and protect the heel will create less tension in the tendon. Using arch supports inside the shoe, if the shoe is in good condition but doesn't provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely. Stretching, doing this before and after exercising helps to keep the Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility. Gradually increasing the intensity of a workout - Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your muscles time to loosen up and puts less pressure on the tendon.

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