Achilles tendinitis is when the
tendon that connects the back of your leg to your heel becomes swollen and painful near the bottom of the foot. This tendon is called the Achilles tendon. It is used for walking, running, and
Achilles tendinitis is caused by repeated stress to the tendon, not a direct injury. Often times, this can happen from doing too much too soon and not giving your body enough time to rest or adjust
to the increase in intensity or amount of exercise. Another contributing factor can be tight calf muscles. Having tight calf muscles and starting an activity can put added stress on the achilles
Symptoms vary because you can injure various areas of the muscle-tendon complex. The pain may be an acute or chronic sharp, stabbing, piercing, shooting, burning or aching. It is often most
noticeable immediately after getting out of bed in the morning, or after periods of inactivity, like sitting down for lunch. After a couple minutes of walking around, it will often then settle down
somewhat, before becoming symptomatic again after excessive time standing or walking. But regardless of how the pain is perceived, Achilles tendon pain should not be left untreated due to the danger
that the tendon can become weak, frayed, thickened, and eventually it may rupture.
Confirming Achilles tendonitis may involve imaging tests. X-rays provide images of the bones of the foot and leg. Magnetic resonance imaging (MRI) is useful for detecting ruptures and degeneration of
tissue. Ultrasound shows tendon movement, related damage, and inflammation.
Treatment will depend on the severity of the injury. In general terms, the longer the symptoms are present before treatment begins, the longer the timeframe until complete recovery is achieved.
Complete recovery can take between three and nine months. Initial treatment of Achilles tendonitis includes, Rest, to avoid further injury to the area. Ice, to reduce inflammation, Elevation, to
reduce swelling. Bandaging or strapping, to support the area and restrict movement of the tendon. Anti-inflammatory medications to reduce pain and inflammation. (Cortisone (steroid) injections to
reduce inflammation are not usually recommended as they may weaken the tendon and increase the risk of rupture). Other treatments include, Physiotherapy, Physiotherapy plays an important role in the
treatment of Achilles tendonitis. This generally focuses on two main areas - treatment and rehabilitation. Treatment may involve such techniques as massage, ultrasound, acupuncture and gentle
stretching. Rehabilitation involves the development of an individualised recovery programme, the most important aspect of which is strengthening. Strengthening of the muscles surrounding the Achilles
tendon helps to promote healing in the tendon itself. Strengthening is achieved through the use of specific exercises, which will be taught by the physiotherapist. One such exercise is eccentric
loading, which involves contracting the calf muscle while it is being stretched. It is common for the rehabilitation programme to take up to three months. Podiatry, including gait analysis and the
fitting of orthotic devices to support the foot and reduce stress on the tendon, may be recommended. For cases of Achilles tendonitis that do not respond to initial treatment, casting or splinting of
the affected foot may be recommended to allow it to rest completely.
Surgical treatment for tendons that fail to respond to conservative treatment can involve several procedures, all of which are designed to irritate the tendon and initiate a chemically mediated
healing response. These procedures range from more simple procedures such as percutaneous tenotomy61 to open procedures and removal of tendon pathology. Percutaneous tenotomy resulted in 75% of
patients reporting good or excellent results after 18 months. Open surgery for Achilles tendinopathy has shown that the outcomes are better for those tendons without a focal lesion compared with
those with a focal area of tendinopathy.62 At 7 months after surgery, 67% had returned to physical activity, 88% from the no-lesion group and 50% from the group with a focal lesion.
Stay in good shape year-round and try to keep your muscles as strong as they can be. Strong, flexible muscles work more efficiently and put less stress on your tendon. Increase the intensity and
length of your exercise sessions gradually. This is especially important if you've been inactive for a while or you're new to a sport. Always warm up before you go for a run or play a sport. If your
muscles are tight, your Achilles tendons have to work harder to compensate. Stretch it out. Stretch your legs, especially your calves, hamstrings, quadriceps, and thigh muscles - these muscles help
stabilize your knee while running. Get shoes that fit properly and are designed for your sport. If you're a jogger, go to a running specialty store and have a trained professional help you select
shoes that match your foot type and offer plenty of support. Replace your shoes before they become worn out. Try to run on softer surfaces like grass, dirt trails, or synthetic tracks. Hard surfaces
like concrete or asphalt can put extra pressure on the joints. Also avoid running up or down hills as much as possible. Vary your exercise routine. Work different muscle groups to keep yourself in
good overall shape and keep individual muscles from getting overused. If you notice any symptoms of Achilles tendonitis, stop running or doing activities that put stress on your feet. Wait until all
the pain is gone or you have been cleared to start participating again by a doctor.