Achilles Tendonitis – Symptoms, Causes and Treatment

The Achilles tendon — a strong fibrous cord that connects the muscles in the back of your lower leg (gastrocnemius and soleus) to the back of your heel (calcaneus).This large tendon helps you point your foot downward, elevate on your toes and push off your foot as you ambulate. Every time you move your foot, chances are you are utilizing your Achilles tendon. Under too much stress, the tendon can become overworked. This generally leads to inflammation of the tendon or tendonitis. If not addressed, this inflammation can produce scar tissue thus decreasing the range of motion in the tendon. This could potentially lead to more problems. If you overstretch your Achilles tendon, it can tear (rupture). A rupture can be partial or complete. Usually the rupture occurs just above your heel bone, but it can happen anywhere along the tendon. Another common problem that can occur at the Achilles tendon includes Bursitis. The bursa is a fluid filled sac that secretes lubricant to enables movement at the joints to be smooth and frictionless. Think of it as WD–40 for the body. Inflammation can occur in the bursa between your heel bone and your Achilles tendon. This type of bursitis is called Retrocalcaneal Bursitis. Achilles tendinitis is the inflammation of your Achilles tendon. Symptoms for this may include:

* Pain along the back of the tendon, frequently closest to the heel
* Decreased R.O.M. (Range of Motion) at the ankle
* Heat or redness over the painful area
* Bump or build up of scar tissue that can be palpated at the tendon
* Snapping noise from scar tissue when movement at the ankle occurs.

Common Causes of Achilles Tendinitis are:

* Tight, weak or fatigued gastroc muscles
* Too much, too soon with hill runs o

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r speed workouts
* Worn out or inflexible running shoes
* Individuals who overpronate
* Flat feet.

In addition, injuries can often result from taking part in an activity involving quick directional changes for which you’re not conditioned or for which you haven’t stretched properly. Playing tennis, racquetball or basketball for the middle–aged weekend warrior is very common for this particular injury. Treatments include:

* Apply cold therapy 15 minutes several times a day until inflammation subsides with compression and rest.
* Stop running (if you are a runner)
* Continue use of cold after exercise to prevent re–occurring injury
* Consider short term usage of aspirin or ibuprofen for inflammation and pain only if approved by M.D.
* Massage the knotted area several times a day
* Stretch the gastroc /soleus area
*Work your way back slowly.

Do not begin running until strength and flexibility have returned to the area. This is the hardest part for the avid runner and most athletes to fathom. The good news is that the cardiovascular or aerobic component of exercise can still be addressed in a more protected temporary environment. Consider swimming or aquatic running/exercise in deep water progressing to shallow water as well as doing calf stretches and raises in the pool. Balance training and directional hops can be added with increased weight bearing as tolerated. Consult your local physical therapist for a complete exercise program. Last but not least, a gait analysis is a vital piece of the rehabilitation puzzle with foot injuries. Along with the initial pain treatment listed above, the use of custom orthotics and/or motion controlling shoes should be evaluated. This can prevent your injury from returning to haunt you in the future.

Article by Shawn J Hickling B.S. P.T.A, Member


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