Do you experience dull pain near the back of your heel or in the back of your leg after your regular run or after playing your favourite sport? When you ramp up your exercise is the pain more severe or prolonged? If so, you may have Achilles tendinitis. The Achilles tendon is the thick, strong, springy band of tissue that connects the muscles from the middle of your calf to your heel bone. You use your Achilles tendon when you walk, run or jump. Achilles tendinitis occurs when the Achilles tendon is repeatedly strained. The Achilles tendon becomes less flexible, weaker and more prone to injury as we age. Middle-aged weekend warriors and runners who suddenly intensify their training often suffer from Achilles tendinitis.
Achilles tendinitis can be caused by any activity that puts stress on your Achilles tendon. Tendinitis can develop if you run or jump more than usual or exercise on a hard surface. Tendinitis can be caused by shoes that do not fit or support your foot and ankle. Tight tendons and muscles, You may have tight hamstring and calf muscles in your upper and lower leg. Your tendons also become stiffer and easier to injure as you get older. Arthritis, Bony growths caused by arthritis can irritate the Achilles tendon, especially around your heel.
The primary symptom of Achilles tendon inflammation is pain in the back of the heel, which initially increases when exercise is begun and often lessens as exercise continues. A complete tear of the Achilles tendon typically occurs with a sudden forceful change in direction when running or playing tennis and is often accompanied by a sensation of having been struck in the back of the ankle and calf with an object such as a baseball bat.
During an examination of the foot and ankle, you doctor will look for the following signs, Achilles tendon swelling or thickening. Bone spurs appearing at the lower part of the tendon at the back of the hell. Pain at the middle or lower area of the Achilles tendon. Limited range of motion of the foot and ankle, and a decreased ability to flex the foot. Your doctor may perform imaging tests, such as X-rays and MRI scans, to make a diagnosis of Achilles tendinitis. X-rays show images of the bones and can help the physician to determine if the Achilles tendon has become hardened, which indicated insertional Achilles tendinitis. MRI scans may not be necessary, but they are important guides if you are recommended to have surgical treatment. An MRI can show the severity of the damage and determine what kind of procedure would be best to address the condition.
Treatment options might include anti-inflammatory medication such as ibuprofen which might help with acute achilles inflammation and pain but has not been proven to be beneficial long term and may even inhibit healing. If the injury is severe then a plaster cast might be applied to immobilize the tendon. Use of electrotherapy such as ultrasound treatment, laser therapy and extracorporeal shock wave therapy (ESWT) may be beneficial in reducing pain and encouraging healing. Applying sports massage techniques can mobilze the tissues or the tendon itself and help stretch the calf muscles. Some might give a steroid injection however an injection directly into the tendon is not recommended. Some specialists believe this can increase the risk of a total rupture of the tendon in future. One of the most effective forms of treatment for achilles tendonitis is a full rehabilitation program consisting of eccentric strengthening exercises. There is now considerable evidence suggesting the effectiveness of slow eccentric rehabilitation exercises for curing achilles tendon pain.
Around 1 in 4 people who have persisting pain due to Achilles tendinopathy has surgery to treat the condition. Most people have a good result from surgery and their pain is relieved. Surgery involves either of the following, removing nodules or adhesions (parts of the fibres of the tendon that have stuck together) that have developed within the damaged tendon. Making a lengthways cut in the tendon to help to stimulate and encourage tendon healing. Complications from surgery are not common but, if they do occur, can include problems with wound healing.
To prevent Achilles tendonitis or tendonosis from recurring after surgical or non-surgical treatment, the foot and ankle surgeon may recommend strengthening and stretching of the calf muscles through daily exercises. Wearing proper shoes for the foot type and activity is also important in preventing recurrence of the condition.