Achilles Tendinitis Discomfort Treatment And Cause

Overview

Achilles TendonAchilles tendinitis (or Achilles tendonitis) is a strain of the Achilles tendon, which connects the calf muscles to the heel bone. Pain can be moderate or severe, but the condition is not usually serious. Of course, if you are suffering the leg and heel pain it brings, it certainly feels serious enough.

Causes

The cause of paratenonitis is not well understood although there is a correlation with a recent increase in the intensity of running or jumping workouts. It can be associated with repetitive activities which overload the tendon structure, postural problems such as flatfoot or high-arched foot, or footwear and training issues such as running on uneven or excessively hard ground or running on slanted surfaces. Tendinosis is also associated with the aging process.

Symptoms

In most cases, symptoms of Achilles tendonitis, also sometimes called Achilles tendinitis, develop gradually. Pain may be mild at first and worsen with continued activity. Repeated or continued stress on the Achilles tendon increases inflammation and may cause it to rupture. Partial or complete rupture results in traumatic damage and severe pain, making walking virtually impossible and requiring a long recovery period. Patients with tendinosis may experience a sensation of fullness in the back of the lower leg or develop a hard knot of tissue (nodule).

Diagnosis

Physicians usually pinch your Achilles tendon with their fingers to test for swelling and pain. If the tendon itself is inflamed, your physician may be able to feel warmth and swelling around the tissue, or, in chronic cases, lumps of scar tissue. You will probably be asked to walk around the exam room so your physician can examine your stride. To check for complete rupture of the tendon, your physician may perform the Thompson test. Your physician squeezes your calf; if your Achilles is not torn, the foot will point downward. If your Achilles is torn, the foot will remain in the same position. Should your physician require a closer look, these imaging tests may be performed. X-rays taken from different angles may be used to rule out other problems, such as ankle fractures. MRI (magnetic resonance imaging) uses magnetic waves to create pictures of your ankle that let physicians more clearly look at the tendons surrounding your ankle joint.

Nonsurgical Treatment

As with all conditions, your Doctor should be consulted. Even minor symptoms can represent significant damage to the Achilles tendon. It is recommended that medical advice be sought as soon as symptoms are experienced. Applying ice to the injury on a regular basis can reduce inflammation associated with Achilles Tendonosis. Following the initial injury, ice should be applied for periods of 15 minutes every hour. Resting the injured ankle may be necessary. This can be a problem for athletes who need to train regularly. The degree of rest required depends on the severity and type of Achilles Tendonosis. Your Health Care Professional will advise you about what activities should be limited while the injury is repairing. Fast uphill and downhill running is not advised while an Achilles Tendinosis injury is healing. Anti-inflammatory, analgesic medications such as those containing aspirin may help control pain and inflammation. Self-massage with heat-inducing creams and liniments may be of assistance. Wearing heel-lifts or pads in shoes can reduce the tension in the Achilles tendon. Physiotherapy may assist in the repair of a damaged Achilles tendon. Physiotherapists may recommend exercises to strengthen the tendon to reduce the chances of future injury. Regular stretching of the hamstring muscles (at the back of the calf) can help the repair process. This should only be done when the injury has repaired enough not to cause pain during this stretching. Taping the ankle and wearing appropriate running shoes may help to control movement in the ankle and prevent further injury.

Achilles Tendon

Surgical Treatment

For paratenonitis, a technique called brisement is an option. Local anesthetic is injected into the space between the tendon and its surrounding sheath to break up scar tissue. This can be beneficial in earlier stages of the problem 30 to 50 percent of the time, but may need to be repeated two to three times. Surgery consists of cutting out the surrounding thickened and scarred sheath. The tendon itself is also explored and any split tears within the tendon are repaired. Motion is started almost immediately to prevent repeat scarring of the tendon to the sheath and overlying soft tissue, and weight-bearing should follow as soon as pain and swelling permit, usually less than one to two weeks. Return to competitive activity takes three to six months. Since tendinosis involves changes in the substance of the tendon, brisement is of no benefit. Surgery consists of cutting out scar tissue and calcification deposits within the tendon. Abnormal tissue is excised until tissue with normal appearance appears. The tendon is then repaired with suture. In older patients or when more than 50 percent of the tendon is removed, one of the other tendons at the back of the ankle is transferred to the heel bone to assist the Achilles tendon with strength as well as provide better blood supply to this area.

Prevention

Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining an adequate level of fitness for your sport. Avoid dramatic increases in sports training. If you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse. Wear good quality supportive shoes appropriate to your sport. If there is foot deformity or flattening, obtain orthoses. Avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury. Maintain a normal healthy weight.

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