Achilles tendonitis is
commonly seen in athletes who sustain an increase in training load, and is most often due to overuse. Tendons respond poorly to overuse, therefore healing is slow. This can leave a tendon
pathologically defective, which decreases tendon strength and leaves it less able to tolerate load, thus vulnerable to further injury or tendinosis. Extrinsic factors contributing to this condition
include training errors and inappropriate footwear. Intrinsic factors include inflexibility, weakness and malalignment. In other situations, there will be clinical inflammation, but objective
pathologic evidence for cellular inflammation is lacking, and in these conditions the term tendinosis is more appropriate. Tendinosis is a degeneration of the tendon?s collagen in response to chronic
overuse; when overuse is continued without giving the tendon time to heal and rest, such as with repetitive strain injury, tendinosis results. Even tiny movements, such as clicking a mouse, can cause
tendinosis, when done repeatedly.
Tendinitis most often occurs when a tendon is over used. As the foot extends the Achilles tendon engages the calf muscles. The calf muscle generates force, which is transferred to the foot via this
tendon. As this action repeats the tendon will endure large amounts of stress. An under-trained or inexperienced athlete is most likely to be affected by tendinitis since their body is not accustomed
to the stress involved with athletics. Improper foot mechanics is another common cause of Achilles tendinitis. A properly functioning foot will distribute weight evenly across the foot. On the
contrary, if the foot is experiencing improper mechanics, the weight of the body will not be evenly distributed. This can result in tendinitis, plantar fasciitis, calluses, bunions, neuromas and much
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.
If you think you have Achilles tendinitis, make an appointment to see your doctor. The doctor will ask you questions about your recent activity and look for signs. The foot not flexing when the calf
muscle is pressed ( if Achilles ruptures or tears in half). Swelling on the back of the foot. Pain in the back of the foot. Limited range of motion in ankle. An X-ray or MRI scan can check for
Treatment approaches for Achilles tendonitis or tendonosis are selected on the basis of how long the injury has been present and the degree of damage to the tendon. In the early stage, when there is
sudden (acute) inflammation, one or more of the following options may be recommended. Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through
the Achilles tendon and promote healing. Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice
directly against the skin. Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the
condition. Orthotics. For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed. Night splints. Night splints help to maintain a stretch in the Achilles tendon
during sleep. Physical therapy. Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait and running re-education, stretching, and ultrasound therapy.
Achilles tendon repair surgery is often used to repair a ruptured or torn Achilles tendon, the strong fibrous cord that connects the two large muscles in the back of your calf to your heel bone.
These muscles (the gastrocnemius and the soleus) create the power needed to push off with your foot or rise up on your toes. Achilles tendon ruptures are quite common. Most happen during recreational
activities that require sudden bursts of muscle power in the legs. Often a torn Achilles tendon can be diagnosed with a physical examination. If swelling is present, the orthopaedist may delay the
Achilles tendon surgery until it subsides.
While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk. Increase your activity level gradually. If you're just beginning an exercise regimen, start
slowly and gradually increase the duration and intensity of the training. Take it easy. Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in a
strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest. Choose your shoes carefully. The shoes you wear while exercising
should provide adequate cushioning for your heel and should have a firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good
condition but don't support your feet, try arch supports in both shoes. Stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise and after
exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis. Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendon to
better handle the stresses they encounter with activity and exercise. Cross-train. Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and