Achilles Tendonitis Ache Treatment And Cause
The Achilles tendon connects the calf muscle to the back of the heel. Injuries to the Achilles tendon are common, as it is in constant use during walking and running. These injuries, known as Achilles tendinitis, are usually the result of overuse damage and minor tears that have accumulated over years. Your risk of developing Achilles tendinitis increases with age and activity level. Many athletes develop Achilles tendinitis. The tendon may be injured several inches away from where it attaches to the foot or at the point of attachment. An injury at the point of attachment is called Achilles enthesopathy. We recommend a combination of treatments over a period of months that may include wearing supportive shoes or orthotic devices, performing stretching exercises, and icing the affected area. If these treatments are not effective, or if the tendon is completely torn, we may recommend surgery.
Achilles tendinitis is caused by repeated stress to the tendon, not a direct injury. Often times, this can happen from doing too much too soon and not giving your body enough time to rest or adjust to the increase in intensity or amount of exercise. Another contributing factor can be tight calf muscles. Having tight calf muscles and starting an activity can put added stress on the achilles tendon.
If you have Achilles tendinitis or Achilles enthesopathy, you are likely to experience the following symptoms. Pain. You may notice aching, burning, or tearing pains at the back of your heel or above the ankle. The pain can range from mild to very severe and disabling. It is most noticeable in the following circumstances. After resting. Many people report that pain increases when they first get out of bed in the morning or after sitting for a period of time. After exercise. Pain may increase if you exercise or stand for a period of time. A lump. In some cases, a tender lump can develop at the site of the injured tendon (tendinosis). Bone spurs. When the injury occurs at the point where the tendon attaches to the foot, a bone spur may develop on the heel.
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.
Treatment will focus on relieving the pain and preventing further injury. Your podiatrist may create shoe inserts or a soft cast to effectively immobilize the affected area for a period of time. (Often, a couple of weeks are needed for the tendon to heal.) Medication can help too. Your podiatrist may recommend or prescribe oral medication.
There are two types of Achilles repair surgery for tendonitis (inflammation of the Achilles Tendon), if nonsurgical treatments aren't effective. Gastrocnemius recession - The orthopaedic surgeon lengthens the calf muscles to reduce stress on your Achilles tendon. D?bridement and repair - During this procedure, the surgeon removes the damaged part of the Achilles tendon and repairs the remaining tendon with sutures or stitches. Debridement is done when the tendon has less than 50% damage.
Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining an adequate level of fitness for your sport. Avoid dramatic increases in sports training. If you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse. Wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses. Avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury. Maintain a normal healthy weight.