Achilles Tendonitis is a
term that commonly refers to an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common especially to joggers and jumpers, due to the repetitive action and so may
occur in other activities that requires the same repetitive action. Most experts now use the term Achilles tendinopathy to include both inflammation and micro-tears. But many doctors may still use
the term tendonitis out of habit.
Achilles tendinitis is usually caused by straining the Achilles tendon through intense activity or a sudden increase in exercise. Individuals who play basketball often develop Achilles tendinitis as
a result of pivoting, jumping, and running. These repetitive movements put pressure on the tendon and can gradually wear it down over time. Increasing the intensity of your workouts may also lead to
the development of Achilles tendinitis. This is commonly seen in long distance runners who do quite a bit of uphill running. Similarly, if you start exercising more frequently you may also develop
the condition due to overuse of the tendon. Not stretching properly before exercise can also make the tendon more prone to injury. Achilles tendinitis is also common in individuals whose feet have a
flattened arch, as this places more stress on the tendon. The condition can also be triggered by arthritis, as joint pain can cause one to compensate by putting more pressure on the Achilles
The symptoms associated with Achilles tendonitis and tendonosis include, Pain-aching, stiffness, soreness, or tenderness-within the tendon. This may occur anywhere along the tendon?s path, beginning
with the tendon?s attachment directly above the heel upward to the region just below the calf muscle. Often pain appears upon arising in the morning or after periods of rest, then improves somewhat
with motion but later worsens with increased activity. Tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. There is less tenderness, however, when pressing directly on
the back of the tendon. When the disorder progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged.
There is enlargement and warmth of the tendon 1 to 4 inches above its heel insertion. Pain and sometimes a scratching feeling may be created by gently squeezing the tendon between the thumb and
forefinger during ankle motion. There may be weakness in push-off strength with walking. Magnetic resonance imaging (MRI) can define the extent of degeneration, the degree to which the tendon sheath
is involved and the presence of other problems in this area, but the diagnosis is mostly clinical.
Physical therapy is the first and most useful defense for achilles tendonitis because of the two presentations outlined above. Treatments for the two types are quite different in approach.
Midsubstance tendinitis responds well to stretching, whereas insertional tendnitis tends to be aggravated more by it. Depend on your trusted physical therapist to differentiate between the two and
follow their guidelines on exercises and running modifications. Running gait patterns that show excessive ?sinking postures? tend to point to the source of achilles tendon problems. Altering your
gait in the midstance phase of the cycle can reduce the load on the tendon dramatically and thereby reduce pain. Rely on your running physical therapist for proper guidance on altering your gait the
right way. Stride Strong?s Portland Running Clinic gait analysis can identify and fix potential issues before pain sets in. Icing at the onset of acute achilles pain (i.e. when the injury is fresh
and new) would help control the inflammation. Your next step should be to call our number for an appointment.
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.
Stay in good shape year-round and try to keep your muscles as strong as they can be. Strong, flexible muscles work more efficiently and put less stress on your tendon. Increase the intensity and
length of your exercise sessions gradually. This is especially important if you've been inactive for a while or you're new to a sport. Always warm up before you go for a run or play a sport. If your
muscles are tight, your Achilles tendons have to work harder to compensate. Stretch it out. Stretch your legs, especially your calves, hamstrings, quadriceps, and thigh muscles - these muscles help
stabilize your knee while running. Get shoes that fit properly and are designed for your sport. If you're a jogger, go to a running specialty store and have a trained professional help you select
shoes that match your foot type and offer plenty of support. Replace your shoes before they become worn out. Try to run on softer surfaces like grass, dirt trails, or synthetic tracks. Hard surfaces
like concrete or asphalt can put extra pressure on the joints. Also avoid running up or down hills as much as possible. Vary your exercise routine. Work different muscle groups to keep yourself in
good overall shape and keep individual muscles from getting overused. If you notice any symptoms of Achilles tendonitis, stop running or doing activities that put stress on your feet. Wait until all
the pain is gone or you have been cleared to start participating again by a doctor.