Archive for category Achilles Tendon
Achilles tendinitis, also known as Achilles tendonitis, is inflammation of the Achilles tendon. The Achilles tendon connects your calf muscles to the back of your heel bone. It allows extension of your foot downward, away from your body, which lets your heel lift off the ground as you move forward when walking. Every time you take a step you rely on your Achilles tendon.
Although a specific incident of overstretching can cause an Achilles tendon disorder, these injuries typically result from a gradually progressive overload of the Achilles tendon or its attachment to bone. The cause of this chronic overload is usually a combination of factors that can put excess stress on the tendon: being overweight, having a tight calf muscle, standing or walking for a long period of time, wearing excessively stiff or flat footwear, or engaging in significant sports activity.
The main complaint associated with Achilles tendonitis is pain behind the heel. The pain is often most prominent in an area about 2-4 centimeters above where the tendon attaches to the heel. In this location, called the watershed zone of the tendon, the blood supply to the tendon makes this area particularly susceptible. Patients with Achilles tendonitis usually experience the most significant pain after periods of inactivity. Therefore patients tend to experience pain after first walking in the morning and when getting up after sitting for long periods of time. Patients will also experience pain while participating in activities, such as when running or jumping. Achilles tendonitis pain associated with exercise is most significant when pushing off or jumping.
The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes. X-rays can help diagnose bone problems. An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.
Initial treatment consists of medication and ice to relieve the pain, stretching and strengthening exercises, and modification of the activity that initially caused the problem. These all can be carried out at home, although referral to a physical therapist or athletic trainer for further evaluation and treatment may be helpful. Occasionally a walking boot or cast may be recommended to immobilize the tendon, allowing the inflammation to settle down. For less severe cases or after immobilization, a heel lift may be prescribed to reduce stress to the tendon. This may be followed by an elastic bandage wrap of the ankle and Achilles tendon. Orthotics (arch supports) may be prescribed or recommended by your physician. Surgery to remove the inflamed tendon lining or degenerated tendon tissue is rarely necessary and has shown less than predictable results.
Most people will improve with simple measures or physiotherapy. A small number continue to have major problems which interfere with their lifestyle. In this situation an operation may be considered. If an operation is being considered, the surgeon will interview you and examine you again and may want you to have further treatment before making a decision about an operation. Before undergoing Achilles tendonitis surgery, London based patients, and those who can travel, will be advised to undergo a scan, which will reveal whether there is a problem in the tendon which can be corrected by surgery. Patients will also have the opportunity to ask any questions and raise any concerns that they may have, so that they can proceed with the treatment with peace of mind.
Do strengthening and stretching exercises to keep calf muscles strong and flexible. Keep your hamstring muscles flexible by stretching. Warm up and stretch adequately before participating in any sports. Always increase the intensity and duration of training gradually. Do not continue an exercise if you experience pain over the tendon. Wear properly fitted running and other sports shoes, including properly fitted arch supports if your feet roll inwards excessively (over-pronate).