tendonitis (tendinitis), is a painful and often debilitating inflammation of the Achilles tendon than can progress into degeneration which we call Achilles Tendinosis. The Achilles tendon is the
largest and strongest tendon in the body. It is located in the back of the lower leg, attaches to the heel bone (calcaneus), and connects the calf muscles to the heel bone. In most cases, Achilles
tendonopathy's are overuse injuries are more common among athletes and people who train heavily, however it can also occur in people who are less active. Achilles Tendonitis can vary in severity from
a mild pain in the tendon during a particular activity to more severe cases when any form of activity that puts strain on this ligament, even standing or walking, can cause pain.
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.
Symptoms of Achilles Tendinitis include the following. Pain and stiffness along the Achilles tendon in the morning. Pain along the tendon or back of the heel that worsens with activity. Severe pain
the day after exercising. Thickening of the tendon. Bone spur (insertional tendinitis). Swelling that is present all the time and gets worse throughout the day with activity. If you have an Achilles
tendon rupture, you might feel a pop or snap, accompanied by a sharp pain behind your ankle. You are likely to have difficulty walking properly. If you have ruptured your Achilles tendon then surgery
is likely to be the best treatment option.
Studies such as x-rays and MRIs are not usually needed to make the diagnosis of tendonitis. While they are not needed for diagnosis of tendonitis, x-rays may be performed to ensure there is no other
problem, such as a fracture, that could be causing the symptoms of pain and swelling. X-rays may show evidence of swelling around the tendon. MRIs are also good tests identify swelling, and will show
evidence of tendonitis. However, these tests are not usually needed to confirm the diagnosis; MRIs are usually only performed if there is a suspicion of another problem that could be causing the
symptoms. Once the diagnosis of tendonitis is confirmed, the next step is to proceed with appropriate treatment. Treatment depends on the specific type of tendonitis. Once the specific diagnosis is
confirmed, the appropriate treatment of tendonitis can be initiated.
Your podiatrist may recommend one or more of these treatments to manage your pain. A bandage specifically designed to restrict motion of the tendon. Over the counter, non-steroidal anti-inflammatory
medication (ibuprofen). Custom orthotic shoe inserts to relieve stress on the tendon. Rest. Switching to a low impact exercise such as swimming, that does not stress the tendon. Stretching, massage,
ultrasound and appropriate exercises to strengthen the muscles that support the achilles tendon. In extreme cases, surgery is necessary to remove the damaged tissue and repair any tears.
If non-surgical treatment fails to cure the condition then surgery can be considered. This is more likely to be the case if the pain has been present for six months or more. The nature of the surgery
depends if you have insertional, or non-insertional disease. In non-insertional tendonosis the damaged tendon is thinned and cleaned. The damage is then repaired. If there is extensive damage one of
the tendons which moves your big toe (the flexor hallucis longus) may be used to reinforce the damaged Achilles tendon. In insertional tendonosis there is often rubbing of the tendon by a prominent
part of the heel bone. This bone is removed. In removing the bone the attachment of the tendon to the bone may be weakened. In these cases the attachment of the tendon to the bone may need to be
reinforced with sutures and bone anchors.
If you're just getting started with your training, be sure to stretch after running, and start slowly, increasing your mileage by no more than 10% per week. Strengthen your calf muscles with
exercises such as toe raises. Work low-impact cross-training activities, such as cycling and swimming, into your training.