The Major Causes And Treatment Plans For Achilles Tendinitis Discomfort

Overview
Achilles Tendinitis is a painful condition. Running and walking are made possible by the Achilles tendon, which attaches the calf muscle to the heel bone. Strenuous exercise, jumping, and climbing are all movements that can strain the tendon and calf muscles, causing an inflammation known as tendinitis. The injury to the Achilles can be mild, requiring only rest and over-the-counter anti-inflammatory drugs, or severe, necessitating surgical repair of the damaged tendon. Chronic Achilles tendinitis can lead to micro tears in the tissue (tendinosis), which weaken the tendon and put it at risk for severe damage such as a tear or rupture.

Causes
Achilles tendinitis usually results from overuse and not a specific injury or trauma. When the body is subject to repetitive stress, the Achilles tendon is more prone to become inflamed. Other factors may cause Achilles tendinitis, such as, Sudden increase in physical activity, which can be related to distance, speed or hills, without giving yourself adequate time to adjust to the heightened activity. With running up hills, the Achilles tendon has to stretch more for each stride, which creates rapid fatigue. Inadequate footwear or training surface. High heels may cause a problem, because the Achilles tendon and calf muscles are shortened. While exercising in flat, athletic shoes, the tendon is then stretched beyond its normal range, putting abnormal strain on the tendon. Tight calf muscles which gives the foot a decreased range of motion. The strained calf muscles may also put extra strain on the Achilles tendon. Bone spur where the Achilles tendon attaches to the heel bone, aggravating the tendon and causing pain.

Symptoms
There will be a gradual onset of achilles tendon pain over a period of weeks, or even months. The pain will come on during exercise and is constant throughout the training session. Pain will be felt in the achilles tendon when walking especially up hill or up stairs. This is because the achilles is having to stretch further than normal. There is likely to be stiffness in the Achilles tendon especially in the morning or after a long period of rest. This is thought to be due to adhesions between the tendon sheath and the tendon itself. Nodules or lumps may be found in the achilles tendon, particularly 2-4cm above the heel and the skin will appear red. Pain and tenderness will be felt when pressing in on the achilles tendon which is likely to appear thickened or swollen. A creaking sensation may be felt when press the fingers into the sides of the tendon and moving the ankle.This is known as crepitus.

Diagnosis
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.

Nonsurgical Treatment
NSAIDS like ibuprofen are often prescribed to help manage the pain and inflammation. Steroids are often recommended when patients do not respond to NSAID treatment. They are often most effective when injected directly into the inflamed and swollen area. Physiotherapy is a great way to stretch and strengthen the Achilles tendon. A good physical therapist will also teach the patient techniques which give better foot support during exercise (taping, wrapping, etc?). Orthotics, assistive devices and insoles can be used to cushion and cradle the arch of the foot during the healing process. Shock Wave Therapy. This is the newest form of treatment and uses concentrated sound waves to stimulate healing in the affected area. This form of treatment is reserved for heel pain that is unresponsive to other forms of treatment.


Surgical Treatment
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.

Prevention
There are several things you can do to reduce the risk of Achilles tendinitis, warm up every time before you exercise or play a sport. Switch up your exercises. Slowly increase the length and intensity of your workouts. Keep your muscles active and stay in shape all year-round. When you see symptoms of Achilles tendinitis, stop whatever activity you are doing and rest.