If you have pain along the back of
your leg near your heel, you may have Achilles tendonitis. Achilles tendonitis is an overuse injury that commonly occurs in runners and ?weekend warriors?. The Achilles tendon is the largest tendon
in the body. Named after a tragic hero from Greek mythology, it connects your calf muscle to your heel bone to allow you to jump, run and walk. Achilles tendonitis is most common in middle-aged men,
but it can happen to anyone who has a sudden increase in physical activity. The risk is increased if you also have tight calf muscles and/or a flat arch in your foot. Other risk factors include
running in worn out shoes, cold weather, frequently running uphill or if you suffer from medical conditions such as diabetes or high blood pressure. There are two main types of Achilles tendinitis:
insertional and noninsertional. Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches to the heel bone. Noninsertional Achilles tendinitis is when the
fibers in the middle portion of the tendon have started to break down with tiny tears, swell, and/or thicken. This type is more often seen in younger, active people. Both types can also cause bone
spurs. Achilles tendonitis should be diagnosed by your doctor. However, if you experienced a sudden ?pop? in the back of your calf or heel, this might be something more serious like a ruptured or
torn Achilles tendon. If this happens, see your doctor immediately.
The two most common causes of Achilles tendonitis are Lack of flexibility and Overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise
training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age,
tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles
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.
A doctor or professional therapist will confirm a diagnosis, identify and correct possible causes, apply treatment and prescribe eccentric rehabilitation exercises. An MRI or Ultrasound scan can
determine the extent of the injury and indicate a precise diagnosis. Gait analysis along with a physical assessment will identify any possible biomechanical factors such as over pronation which may
have contributed to the achilles tendonitis and training methods will be considered. Biomechanical problems can be corrected with the use of orthotic inserts and selection of correct footwear.
There are a variety of treatments for Achilles tendonitis. These range from rest and aspirin to steroid injections and surgery. Your doctor might suggest, reducing your physical activity, stretching
and strengthening the calf muscles, switching to a different, less strenuous sport, icing the area after exercise or when in pain, raising your foot to decrease swelling, wearing a brace or
compressive elastic bandage to prevent heel movement, undergoing physical therapy, taking anti-inflammatory medication (e.g., aspirin or ibuprofen) for a limited time, getting steroid injections,
Sometimes more conservative treatments are not effective. In these cases, surgery may be necessary to repair the Achilles tendon. If the condition intensifies and is left untreated, there?s a greater
risk of an Achilles rupture. This can cause sharp pain in the heel area.
Many people don't realize that Achilles tendon surgery can be very traumatic to your body. The type of trauma you experience after surgery can be compared to what you go through when you first
injured your Achilles tendon. During the first 24 to 72 hours after the surgery your ankle will be tender, swollen and very painful. Your leg will be weak and unstable making it impossible for you to
put weight on your leg without some kind of help. This is why your doctor or surgeon will have you outfitted for a cast, ankle brace and/or crutches before the procedure. When you are relying on a
cast/brace and crutches your Achilles tendon is less likely to be as active as it once was. This is usually why atrophy (loss) of your lower leg muscles (specifically your calf muscle) happens. In
general, more than 80%* of people who undergo surgery for an injured Achilles Tendon are able to return to their active lifestyle. In order to avoid re-injury, it is important to commit to a regular
conservative therapy routine.
Stretching of the gastrocnemius (keep knee straight) and soleus (keep knee bent) muscles. Hold each stretch for 30 seconds, relax slowly. Repeat stretches 2 - 3 times per day. Remember to stretch
well before running strengthening of foot and calf muscles (eg, heel raises) correct shoes, specifically motion-control shoes and orthotics to correct overpronation. Gradual progression of training
programme. Avoid excessive hill training. Incorporate rest into training programme.