Tendinitis is the inflammation of
a tendon. Tendons are thick cords of tissue that connect muscles to bone. Achilles tendinitis, or an inflammation of the Achilles tendon, is one of the most common causes of foot or ankle pain. Other
types of foot/ankle tendinitis include posterior tibial tendinitis and peroneal tendinitis.
Tight or fatigued calf muscles, which transfer the burden of running to the Achilles. This can be due to poor stretching, rapidly increasing distance, or over-training excessive hill running or speed
work, both of which stress the Achilles more than other types of running. Inflexible running shoes, which, in some cases, may force the Achilles to twist. Runners who overpronate (feet rotate too far
inward on impact) are most susceptible to Achilles tendinitis.
People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the
ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis
can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture.
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.
The aim, when treating Achilles tendinitis, is to relieve pain and reduce swelling. The kind of treatment used can vary, based on the severity of the condition and whether or not the patient is a
professional athlete. After diagnosis, the doctor will decide which method of treatment is required for the patient to undergo, it is likely that they will suggest a combination. Stretching achilles
tendon, a doctor might show the patient some stretching exercises that help the Achilles tendon heal, as well as preventing future injury. Methods used to treat Achilles tendinitis include, ice packs
- applying these to the tendon, when in pain or after exercising, can alleviate the pain and inflammation. Resting, this gives the tissue time to heal. The type of rest needed depends on the severity
of the symptoms. In mild cases of Achilles tendinitis, it may mean just reducing the intensity of a workout, in severe cases it might mean complete rest for days or weeks. Elevating the foot,
swelling can be reduced if the foot is kept raised above the level of the heart. Exercise and stretching, a doctor might show the patient some stretching exercises that help the Achilles tendon heal,
as well as preventing future injury. They may, instead, refer the patient to a physiotherapist or another specialist. The exercises learned will improve the flexibility of the area and likely
increase calf strength. Pain relievers - non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen can reduce pain and swelling. If you suffer from asthma, kidney disease or liver disease do
not take NSAIDs without first checking with your doctor. Steroid injections, these can reduce tendon swelling, but should be performed with caution, as this process has been associated with a greater
risk of tendon rupture. A doctor would likely perform the injection while scanning the area with ultrasound to reduce this risk. Compression bandages and orthotic devices, such as ankle supports and
shoe inserts can aid recovery as they take the stress off the Achilles tendon.
Surgery usually isn't needed to treat Achilles tendinopathy. But in rare cases, someone might consider surgery when rubbing between the tendon and the tissue covering the tendon (tendon sheath)
causes the sheath to become thick and fibrous. Surgery can be done to remove the fibrous tissue and repair any small tendon tears. This may also help prevent an Achilles tendon rupture.
Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain 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.