Precisely What Will Cause Tendonitis Of The Achilles

Overview
The Achilles tendon connects the calf muscle to the back of the heel. Injuries to the Achilles tendon are common, as it is in constant use during walking and running. These injuries, known as Achilles tendinitis, are usually the result of overuse damage and minor tears that have accumulated over years. Your risk of developing Achilles tendinitis increases with age and activity level. Many athletes develop Achilles tendinitis. The tendon may be injured several inches away from where it attaches to the foot or at the point of attachment. An injury at the point of attachment is called Achilles enthesopathy. We recommend a combination of treatments over a period of months that may include wearing supportive shoes or orthotic devices, performing stretching exercises, and icing the affected area. If these treatments are not effective, or if the tendon is completely torn, we may recommend surgery.

Causes
The two most common causes of Achilles tendonitis are Lack of flexibility and Overpronation. Other factors associated with Achilles tendonitis are recent changes in footwear, and changes in exercise training schedules. Often long distance runners will have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing. As people age, tendons, like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.

Symptoms
The most common site of Achilles Tendonitis is at the heel to 4 inches above the heel. The diagnosis of this problem is made when the following signs are present. Pain in the Achilles tendon with up and down movement of the foot at the ankle. Pain in the Achilles tendon when you squeeze the tendon from side to side. If you are unable to move the foot either up or down, or you have intense pain when trying to walk, you may have a tear of the Achilles tendon, and you should see a doctor immediately. Also if you have severe pain in the calf, with or without discolorations of the skin, you may have a blood clot, and this is a medical emergency; see a doctor immediately. If you do not fall into either of these categories then try the following suggestions.

Diagnosis
A podiatrist can usually make the diagnosis by clinical history and physical examination alone. Pain with touching or stretching the tendon is typical. There may also be a visible swelling to the tendon. The patient frequently has difficulty plantarflexing (pushing down the ball of the foot and toes, like one would press on a gas pedal), particularly against resistance. In most cases X-rays don't show much, as they tend to show bone more than soft tissues. But X-rays may show associated degeneration of the heel bone that is common with Achilles Tendon problems. For example, heel spurs, calcification within the tendon, avulsion fractures, periostitis (a bruising of the outer covering of the bone) may all be seen on X-ray. In cases where we are uncertain as to the extent of the damage to the tendon, though, an MRI scan may be necessary, which images the soft tissues better than X-rays. When the tendon is simply inflamed and not severely damaged, the problem may or may not be visible on MRI. It depends upon the severity of the condition.

Nonsurgical Treatment
With proper care for the area, the pain in the tendon should lessen over three weeks, but it should be noted that the healing of the area continues and doesn't even peak until at least six weeks following the initial injury. This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue will continue to form past six weeks in some cases and as long as a year in severe cases. After 6 months this condition is considered chronic and much more difficult to treat. The initial approach to treating Achilles tendonitis is to support and protect the tendons by bracing any areas of the tendon that are being pulled on during use. It is important to loosen up the tendon, lessen the pain, and minimize any inflammation.


Surgical Treatment
In most surgeries, damaged tissue is cleaned out before surgeons make the necessary repairs. However, a new minimally-invasive surgery to repair a torn Achilles tendon actually uses the damaged tissue to help repair the tear. The percutaneous Achilles repair system, or PARS technique, enables surgeons to better repair a torn Achilles tendon through a smaller incision. This procedure was recently performed at Houston Methodist Hospital to treat an NFL cornerback, getting him back on field for this season.

Prevention
Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain 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.