The Achilles tendon connects
the calf muscles in the lower leg to the heel bone. It is the largest yet most exposed tendon in the body. Achilles tendonitis is where the Achilles tendon, and sometimes the protective sheath
through which it moves, becomes inflamed, causing pain and swelling symptoms. Achilles tendonitis (also known as Achilles tendinopathy or tendonosis) is classified as an overuse injury. If left
untreated it can become chronic (long-term), requiring more intensive treatment. Achilles tendonitis can also increase the risk of sustaining an Achilles tendon rupture (tear).
There are a number of causes and risk factors associated with Achilles Tendinitis. One of the most common causes is simply a lack of conditioning. If the tendon, and muscles that connect to the
tendon, have not been trained or conditioned, this can lead to a weakness that may result in an Achilles injury. Overtraining is also associated with Achilles Tendinitis. Doing too much, too soon
places excessive strain on the Achilles tendon and doesn't allow the tendon enough time to recovery properly. Over time small tears and general degeneration result in a weakening of the tendon, which
leads to inflammation and pain. Other causes of Achilles injury include a lack of warming up and stretching. Wearing inadequate footwear, running or training on uneven ground, and simply standing on,
or in something you're not meant to. Biomechanical problems such as high arched feet or flat feet can also lead to Achilles injuries.
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.
Confirming Achilles tendonitis may involve imaging tests. X-rays provide images of the bones of the foot and leg. Magnetic resonance imaging (MRI) is useful for detecting ruptures and degeneration of
tissue. Ultrasound shows tendon movement, related damage, and inflammation.
Achilles tendonitis will often respond to rest or changes in activity, stretching, or ice after activity. Non-steroidal anti- inflammatory drugs (NSAIDs), such as ibuprofen or naproxen may also help.
Physical therapy focusing on stretching and strengthening, massage, alternating hot and cold baths, and ultrasound or sound waves can also help with healing and comfort. The temporary use of a heel
lift or the insertion of an arch support, called an orthotic, into the shoe or sneaker can also help. Although seldom necessary, the ankle may be kept in a short leg cast or splint. Surgery is rarely
needed but can remove bone spurs or the bony prominence of the heel bone. The injection of corticosteroids such as cortisone into the area of the Achilles tendon is usually avoided because it may
cause the tendon to rupture.
Surgery can be done to remove hardened fibrous tissue and repair any small tendon tears as a result of repetitive use injuries. This approach can also be used to help prevent an Achilles tendon
rupture. If your Achilles tendon has already ruptured or torn, Achilles tendon surgery can be used to reattach the ends of the torn tendon. This approach is more thorough and definitive compared to
non surgical treatment options discussed above. Surgical reattachment of the tendon also minimizes the change of re-rupturing the Achilles tendon.
Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining an adequate level of fitness for your sport. Avoid dramatic
increases in sports training. If you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse. Wear good quality supportive shoes
appropriate to your sport. If there is foot deformity or flattening, obtain orthoses. Avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf
muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury. Maintain a normal healthy weight.