All About Achilles Tendonitis

Overview

Achilles TendonitisAchilles tendinitis is a common condition that causes pain along the back of the leg near the heel. The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, and jump. Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis, a condition associated with overuse and degeneration. Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed. Noninsertional Achilles tendinitis, Noninsertional Achilles Tendinitis. In noninsertional In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden). Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active.




Causes

Unusual use or overuse of the lower leg muscles and Achilles tendon is usually the cause of Achilles tendinitis. Repetitive jumping, kicking, and sprinting can lead to Achilles tendinitis in both recreational and competitive athletes. Runners, dancers, and athletes over age 65 are especially at risk. Sudden increases in training or competition can also inflame your Achilles tendon. For example, adding hills, stair-climbing, or sprinting to your running workout puts extra stress on your Achilles tendon. Improper technique during training can also strain the tendon. Intense running or jumping without stretching and strengthening your lower leg muscles can put you at risk regardless of your age or fitness level. Running on tight, exhausted, or fatigued calf muscles can put added stress on your Achilles tendon, as your tendon may not be ready to quickly start a workout after a period of inactivity. Direct blows or other injuries to the ankle, foot, or lower leg may pull your Achilles tendon too far and stretch the tissue. A hard contraction of the calf muscles, such as can happen when you push for the final sprint in a race, can strain the tendon. People whose feet roll inward, a condition called overpronation, are particularly at risk. Sometimes, shoes with too much heel cushioning put extra strain on the Achilles tendon.




Symptoms

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.




Diagnosis

The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further studies are necessary.




Nonsurgical Treatment

Most cases of Achilles tendonitis can be treated at home. Here's what to do. Stop doing the activity that led to the injury. Avoid putting stress on your legs and feet, and give your tendon plenty of time to fully recover. Use the RICE formula. Don't exercise for a few days, or try an exercise that doesn't stress your feet, such as swimming. If necessary, your doctor may recommend that you use crutches or wear a walking boot to keep weight off your foot. Apply an ice pack wrapped in a towel or a cold compress to your tendon for 15 minutes or more after you exercise or if you feel pain in the tendon. Use tape or an athletic wrap to keep swelling down and help support and immobilize the tendon. Lie down and raise your foot above the level of your heart, and if possible, try to sleep with your foot elevated. This will help keep the swelling to a minimum. Take anti-inflammatory medications. Pain relievers like ibuprofen can help ease pain and reduce swelling in the affected area. Stretch and exercise your ankles and calf muscles while you recover. Keeping your muscles, tendons, and ligaments strong and flexible will aid in your recovery and help you keep from reinjuring your Achilles tendon. A doctor or a physical therapist can help you come up with a good exercise program. Try a pair of prescription orthotic inserts for your shoes if your doctor thinks it will help. Sometimes orthotics can be helpful. Talk to your doctor or someone trained in fitting orthotics to find out if they might work for you. Achilles tendon surgery is rarely needed. It's usually only done if the tendon breaks, and then only as a last resort after other methods of therapy have been tried. Most cases of Achilles tendonitis will get better on their own with rest and minor treatment.

Achilles Tendonitis




Surgical Treatment

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.




Prevention

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.

Foot Problems Are Genetic

Elderly individuals (can be called geriatric) are susceptible to a number of foot specific conditions Some of these conditions can leave individuals disabled if they are not prevented and/or taken care of. Some of these common foot related conditions include: arthritis, ingrown toenails, fungal nails, diabetic ulcers, and corns/calluses. It is an interesting fact that if you were to go barefoot every day of your life, you would not suffer with feet corns.

Podiatrists treat bunions, hammertoes, and all sources of toe and forefoot pain more than any other condition, save for heal pain and nail disease. There can be many complex mechanical causes for these conditions, as genetics has only an initial role in most cases of bunions and other toe and foot deformities. These conditions are successfully treated all day long by podiatrists, and should be the obvious first choice in care when foot pain develops. Sprains are a common injury, and often occur in the evenings or weekends after most medical practices are closed. It is very appropriate to present to an urgent care center or emergency room for serious foot and ankle sprains to ensure there is no fracture. These products can burn your skin.

Skin conditions that involve open sores, lesions, or contagions may also be treated with medical ointments and bandages or wraps. Skin disorders that are temporary and merely cosmetic in nature can often be treated with medicated make-up, over-the-counter skin care products, hygiene techniques, and small lifestyle changes. In addition, some skin conditions can be treated or improved with changes in diet. Some skin disorders cannot be prevented; genetic conditions and disorders that are brought on by other illnesses cannot be avoided. However, it is possible to prevent some skin disorders. Learning about proper skin care and skin disorder treatment can be very important for skin health. Some conditions require the attention of a doctor, while others can be safely addressed at home.

Continue to the next page to get tips on treating calluses - a foot condition almost everyone experiences at one time or another. Foot Injuries : Find out how to avoid unpleasant injuries to your feet, or at least reduce pain and prevent infection after they occur, with these simple suggestions. How to Care for Your Feet : Learn how to keep your feet - and yourself - healthy and happy with these tips on caring for your feet, including selecting the right shoes. For ladies that love to wear high heel footwear, the physics are immutable.

When a patient suffers a foot or lower leg injury they should see a podiatrist as soon as possible to receive the appropriate advice and treatment. The podiatrist will need to understand the cause of the injury, any previous injuries and the level of activity prior to the injury occurring. A comprehensive biomechanical assessment of the patient walking or running will then be carried out to outline any issues with foot/knee or hip alignment that may be causing or contributing to the condition. Podiatrists care for any skin and nail problem involving the feet. The skin may turn red, and start peeling.

Since plantar fascia gets tightened while one is asleep, the sudden movement causes stretching of the ligament as one takes the first few steps. While structural foot abnormalities such as high arches or fallen arches can make one more susceptible to plantar fasciitis, wearing old worn-out shoes can also cause stress to the plantar fascia. Those suffering from plantar fasciitis are also at an increased risk of developing heel spurs. Heel spurs, also known as osteophytes, are abnormal bony outgrowths that may develop along the edges of the heel bone. Heel spurs form when the plantar fascia starts pulling at the heel bone or gets torn due to excessive stress. If the heel spurs start impinging on any of the surrounding nerves or the tissues, one is likely to suffer from pain. Plantar fasciitis and heel spurs surely affect one's ability to move about freely. This is the best way to support the arch of the foot. Pain then sets in and you may need surgery.

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