Achilles tendinitis is inflammation of the Achilles tendon, the fibrous tissue that connects the heel to the calf muscles. This condition is often caused by irritation of the
tendon and typically affects those who play sports. However, older individuals who suffer from arthritis may also be affected. Achilles tendinitis is typically the first stage of an Achilles tendon
injury and should be treated right away. Without treatment, the tendon can tear or rupture, which may require surgery.
Most common in middle-aged men. Conditions affecting the foot structure (such as fallen arches). Running on uneven, hilly ground, or in poor quality shoes. Diabetes. High blood pressure. Certain
antibiotics. ?Weekend Warriors?. Recent increase in the intensity of an exercise program. While Achilles tendinitis can flare up with any overuse or strain of the Achilles tendon, it most often
affects middle-aged men, especially if they are ?weekend warriors? who are relatively sedentary during the week, then decide to play basketball or football on Saturday. Those with flat feet or other
structural conditions affecting their feet tend to put excess strain on the Achilles tendon, increasing their chances of developing Achilles tendinitis or even rupturing the tendon. If you are a
runner, be sure to only run in quality running shoes that are supportive and well cushioned, and to be mindful of the surface you?re running on. Uneven surfaces and especially hilly terrain put
additional strain on your Achilles tendon and can lead to the condition.
Pain anywhere along the tendon, but most often on or close to the heel. Swelling of the skin over the tendon, associated with warmth, redness and tenderness. Pain on rising up on the toes and pain
with pushing off on the toes. If you are unable to stand on your toes you may have ruptured the tendon. This requires urgent medical attention. A painful heel for the first few minutes of walking
after waking up in the morning. Stiffness of the ankle, which often improves with mild activity.
The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in
looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further
studies are necessary.
Proper footwear with a strong and secure counter (the heel circumference) may help to encourage heeling of the tendon. A tendinitis will occasionally resolve on it?s own, with rest, ice, and gentle
stretching. If symptoms persist for more than 2 weeks, consult your physician. Your physician may suggest physiotherapy and custom orthotics. Physiotherapy can suggest appropriate exercises and
modalities to aid in the healing process. Custom orthotics can be very successful in treating the problem, as the original cause may be due to an improper alignment of the foot and heel. Re-aligning
the foot to a neutral position may provide an optimal, biomechanically sound environment for healing to occur.
Chronic Achilles tendon tears can be more complicated to repair. A tendon that has torn and retracted (pulled back) into the leg will scar in the shortened position over time. Restoring normal tendon
length is usually not an issue when surgery is performed within a few weeks of the injury. However, when there has been a delay of months or longer, the treatment can be more complicated. Several
procedures can be used to add length to a chronic Achilles tear. A turndown procedure uses tissue folded down from the top of the calf to add length to the Achilles tendon. Tendon transfers from
other tendons of the ankle can also be performed to help restore function of the Achilles. The results of surgery in a chronic situation are seldom as good as an acute repair. However, in some
patients, these procedures can help restore function of a chronically damaged Achilles.
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.