Achilles Tendinitis Discomfort Treatments And Causes
Achilles tendinitis is an overuse injury of the Achilles (uh-KIL-eez) tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (that?s Achilles tendinitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture. Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs. It?s also common in middle-aged people who play sports, such as tennis or basketball, only on the weekends. Most cases of Achilles tendinitis can be treated with relatively simple, at-home care under your doctor?s supervision. Self-care strategies are usually necessary to prevent recurring episodes. More-serious cases of Achilles tendinitis can lead to tendon tears (ruptures) that may require surgical repair.
In some cases, Achilles Tendinitis can be caused by physical activity without a proper warm up or trauma, such as falling, to cause an overstressing of the muscle and tendon. Other causes include repetitive overuse syndrome, such as a job that required frequent heel lifting. Biomechanical causes such as pronation (or fallen arches) will cause the heel (calcaneus) to lean slightly, putting the undue stress on the Achilles tendon and the calf muscles. Most pain can be felt at the back of the heel or the point at which the calf muscle becomes a tendon three quarters of the distance down from the knee. Discomfort can be felt especially when jumping or when lifting the heel off the ground. Swelling and redness can often be seen at the back of the heel and touching the area would cause a tender sensation. In extreme cases, the tendon can become torn or rupture entirely which would cause bruising or an inability to put pressure on the foot.
Recurring localized pain, sometimes severe, along the tendon during or a few hours after running. Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone. Sluggishness in your leg. Mild or severe swelling. Stiffness that generally diminishes as the tendon warms up with use.
A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, heel spurs, calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.
Treating Achilles tendinitis rarely requires much professional intervention. Ease the pain with OTC pain killers. Stretch and strengthen the Achilles tendon. Stop the condition from happening again. Doctors treating Achilles tendinitis will recommend the following options for accomplishing this. Pain Killers - Generally ibuprofen (Advil) or naproxen (Aleve) will ease the mild pain. Physical Therapy, Stretches and exercises devised to lengthen and strengthen the Achilles tendon will help reduce pain and prevent future recurrence. Orthopedic Supports, Heel-elevating insoles or other orthotic devices can reduce the strain on the Achilles tendon, helping ease the inflammation and pain.
Percutaneous Achilles Tendon Surgery. During this procedure the surgeon will make 3 to 4 incisions (approx. 2.5 cm long) on both sides of the Achilles tendon. Small forceps are used to free the tendon sheath (the soft tissue casing around your Achilles tendon) to make room for the surgeon to stitch/suture any tears. Skilled surgeons may perform a percutaneous achilles tendon surgery with ultrasound imaging techniques to allow for blink suturing with stab incisions made by a surgical suture needle. This procedure can be done in 3 different ways depending on the preference and experience of your surgeon. Instead of making several 2.5 cm incisions for this procedure, some surgeons will use guided imaging with an ultrasound to see the Achilles tendon tissue without having to open up your ankle. For this technique, they will use a surgical needle to repeatedly stab your Achilles tendon. These "stab incisions" will allow the surgeon to "blindly" suture your tendon without seeing the actual tissue. As another option - some surgeons will only make 1 to 3 incisions for smaller surgical implements to repair your tendon while relying on imaging ultrasound to see your damaged tissue. During either procedure the use of ultrasound imaging or endoscopic techniques requires a very skilled surgeon.
You can take measures to reduce your risk of developing Achilles Tendinitis. This includes, Increasing your activity level gradually, choosing your shoes carefully, daily stretching and doing exercises to strengthen your calf muscles. As well, applying a small amount ZAX?s Original Heelspur Cream onto your Achilles tendon before and after exercise.