Achilles Tendonitis is often used to describe achilles tendinopathy or pathology of the achilles tendon. These terms are frequently used when the large tendon at the back of the ankle just below the calf muscle becomes inflamed, swollen and painful due to overuse or injury.Another type of achilles tendinopathy includes achilles tendinosis which is quite different to acute achilles tendinitis because it is chronic achiles pain caused by degeneration of the achilles tendon.
Achilles Tendonitis is one of the most common overuse tendon injuries which should always be treated as early as possible. Left untreated, further achilles tendon injury, achilles tendon rupture or chronic achilles tendinosis can occur. Achilles tendon injuries can be quite debilitating. It is usually associated with swelling and pain upon tensioning or squeezing of the achilles tendon at the back of the ankle.
There are several factors that can contribute to achilles tendonitis, the most common being:
Overuse of the muscle/tendon following initial injury to the achilles tendon.
A poorly functioning foot can cause the heel to shift outwards and contribute to a functional "bowing" of the Achilles tendon. This damages the tendon sheath, resulting in painful inflammation of the area. This abnormality should be neutralised using orthoses or foot orthotics to help stop recurrence of tendon injury.
A sudden increase in training, excessive hill running and speed work can also lead to inflammation of the achilles tendon.
Excessive heel cushioning and air-filled shoes can, over a period of time, lose their stability if damaged or worn incorrectly. This can cause the heel to sink into the shoe, while the shoe is absorbing shock. This further stretches the Achilles tendon at a time when the leg and body are moving forward over the foot, thereby increasing strain.
Tight calf and hamstring muscles may contribute to prolonged achilles tendonitis due to the continual "pulling" strain they exert on the tendon.
Achilles tendonitis is a condition that responds well to conservative treatment if treated early. If disregarded, symptoms and treatment can last for several months. Conservative treatment involves:
Your training schedule should be reduced to enable healing of the damaged area. This helps to allow successful and effective treatment administration.
Rest, Ice, Compression and Elevation. As with any acute injury the RICE principle is paramount. Rest with your leg elevated above the level of the heart whenever possible in the first 72 hours after injury. Ice or cold compression should be used in the first three days. DO NOT use heat or massage in the first 72 hours as this can make things worse. Compression is necessary in the early stages of treatment to help fight the inflammation.
These may help decrease the strain and load on the achilles tendon in the short term.
Correction of abnormal body mechanics.
Orthotic devices are designed to allow the foot to function around its normal position, allowing the Achilles to recover and prevent recurrence of the injury.
Extracorporeal Shock Wave Therapy (ESWT)
This is very useful in chronic cases of achilles tendinopathy.
and physical therapy.
Mild stretching, massage and strengthening exercises are prescribed to restore the extensibility of the tendon, increase strength and hasten full recovery.
This may also be required during the initial treatment.
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Foot Pain and Achilles Tendonitis.
WARNING : This information is for educational purposes only and is not intended to replace professional podiatric advice. Treatment will vary between individuals depending upon your diagnosis and presenting complaint. An accurate diagnosis can only be made following personal consultation with a Podiatrist, your Doctor or your foot specialist.
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