Achilles tendinitis is an inflammation
(swelling) of the tendon, which usually occurs as a result of overuse injury. Basketball players are the most susceptible to Achilles tendinitis because of the frequent jumping. Any activity
requiring a constant pushing off the foot, such as running or dancing, may result in swelling of the tendon.
Achilles tendonitis is an overuse injury. Too much too soon is the common cause of overuse injuries, however other factors can contribute to developing the condition. An increase in activity, either
distance, speed or a sudden change to running up hills. As a rule of thumb distance runners should increase their mileage by no more than 10% per week. A change of footwear or training surface for
example suddenly running on soft sand can cause the heel to drop lower than normal making the tendon stretch further than it is used to. Weak calf muscles can tighten or go into partial spasm which
again increases the strain on the achilles tendon by shortening the muscle. Running up hills - the achilles tendon has to stretch more than normal on every stride. This is fine for a while but will
mean the tendon will fatigue sooner than normal. Overpronation or feet which roll in when running can place an increased strain on the achilles tendon. As the foot rolls in (flattens) the lower leg
also rotates inwards which places twisting stresses on the tendon. Wearing high heels constantly shortens the tendon and calf muscles. When exercising in flat running shoes, the tendon is stretched
beyond its normal range which places an abnormal strain on the tendon.
Common symptoms of Achilles tendinitis include weakness in the leg, slight pain above the heel in the lower leg after activity, feeling of stiffness in the leg that usually appears in the morning and
lessens throughout the day, bad pain the day after exercising, pain as you climb stairs or go uphill, swelling in the area of the Achilles tendon, creaking or cracking noise when you press on the
If Achilles tendonitis is suspected, avoid any exercise or activity that causes the pain. It is advisable to see a doctor promptly so that an accurate diagnosis can be made and appropriate treatment
recommended. The doctor will take a full medical history and will ask about the nature and duration of the symptoms. They will perform a physical examination of the affected area. Ultrasound scanning
may be used to assess damage to the tendon or surrounding structures. Occasionally MRI (magnetic resonance imaging) may be recommended. The symptoms of Achilles tendonitis are often similar to
symptoms of other conditions such as partial Achilles tendon rupture and heel bursitis. This can make diagnosis difficult and a referral to an orthopaedic specialist may be required in order for an
accurate diagnosis to be made.
Treatment for Achilles tendonitis, depends on the severity of the injury. If heel pain, tenderness, swelling, or discomfort in the back of the lower leg occurs, physical activity that produces the
symptoms should be discontinued. If the problem returns or persists, a medical professional should be consulted. If pain develops even with proper stretching and training techniques, the patient
should consult a podiatrist to check for hyperpronation and adequate arch support. The addition of an orthotic may be enough to maintain good arch and foot alignment and eliminate pain. If damage to
the tendon is minor, the injury may respond to a simple course of treatment known as RICE (rest, ice, compression, elevation). Patients are advised to rest the tendon by keeping off their feet as
much as possible, apply ice packs for 20 minutes at a time every hour for a day or two to reduce swelling, compress the ankle and foot with a firmly (not tightly) wrapped elastic bandage and elevate
the foot whenever possible to minimize swelling. A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen may be used to reduce pain, swelling, and inflammation.
Treating this surgically, there are numerous methods to repair the tendon. Most commonly, Achilles tendon is exposed through an incision at the back of the ankle. After identifying both ends of
ruptured tendon, the edges got trimmed and then both ends were sutured together with optimal tension. To get a better outcome with fixation, an anchor may have to be in place in calcaneus, provided
the rupture is very low. Care must be taken to avoid injuries to the nerves located adjacent to the tendon.
As with all injuries, prevention is your best defense especially with injuries that are as painful and inconvenient as Achilles tendonitis. Options for how to prevent Achilles tendonitis include,
stretching- Stretching properly, starting slowly, and increasing gradually will be critical if you want to avoid Achilles tendonitis. To help maintain flexibility in the ankle joint, begin each day
with a series of stretches and be certain to stretch prior to, and after, any exercise or excessive physical activity. Orthotics and Heel Support- Bio-mechanically engineered inserts and heel cups
can be placed in your shoes to correct misalignments or bolster the support of your foot and are available without a prescription. The temporary heel padding that these provide reduces the length
that the Achilles tendon stretches each time you step, making it more comfortable to go about your daily routine. Proper Footwear- Low-heeled shoes with good arch support and shock absorption are
best for the health of your foot. Look into heel wedges and other shoe inserts to make sure that your everyday foot mechanics are operating under ideal conditions.