The Primary Causes And Treatment Plans Of Achilles Tendonitis

Overview
Achilles tendinitis. Achilles tendonitis is inflammation of the Achilles tendon, the largest tendon in the body, which runs from the calf to the heel bone. Noninsertional Achilles tendonitis affects fibers in the middle of the tendon. Insertional Achilles tendonitis affects the lower portion of the tendon where it attaches to the heel bone. Both types can result from repetitive stress to the tendon or from overstressing the tendon during exercise. Damaged tendon fibers can calcify and bone spurs can form where the tendon attaches to the bone. Symptoms may include pain and stiffness of the tendon - which may occur from either inactivity (such as first thing in the morning) or after activity - thickening or swelling of the tendon or bone spurs.

Causes
When you place a large amount of stress on your Achilles tendon too quickly, it can become inflamed from tiny tears that occur during the activity. Achilles tendonitis is often a result of overtraining, or doing too much too soon. Excessive hill running can contribute to it. Flattening of the arch of your foot can place you at increased risk of developing Achilles tendonitis because of the extra stress placed on your Achilles tendon when walking or running.

Symptoms
Achilles tendonitis may be felt as a burning pain at the beginning of activity, which gets less during activity and then worsens following activity. The tendon may feel stiff first thing in the morning or at the beginning of exercise. Achilles tendonitis usually causes pain, stiffness, and loss of strength in the affected area. The pain may get worse when you use your Achilles tendon. You may have more pain and stiffness during the night or when you get up in the morning. The area may be tender, red, warm, or swollen if there is inflammation. You may notice a crunchy sound or feeling when you use the tendon.

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
Ask your Pharmacist for advice. 1) Your Pharmacy stocks a range of cold packs which may be applied to the area to decrease inflammation. 2) Ask your Pharmacist about a temporary heel raise or pad which can be inserted into footwear to decrease the force absorbed by the tendon when the feet land heavily on the ground. 3) Gently massaging a heat-producing liniment into the calf can help to relieve tension in the muscle which may relieve the symptoms of Achilles Tendinitis. Ask your Pharmacist to recommend the most appropriate type. 4) Gels, sprays or creams which help to reduce inflammation are available and may be applied to the injured area. Ask your Pharmacist for advice. 5) Your Pharmacist can advise you on analgesic, anti-inflammatory medications such as Aspirin which may be of assistance. Aspirin should be avoided in children under the age of 12 and those aged 12 to 15 who have a fever. 6) Strapping the ankle can help restrict movement and minimise further injury. Your Pharmacist stocks a range of athletic strapping tape and ankle guards which may assist your injury.



Surgical Treatment
Surgery usually isn't needed to treat Achilles tendinopathy. But in rare cases, someone might consider surgery when rubbing between the tendon and the tissue covering the tendon (tendon sheath) causes the sheath to become thick and fibrous. Surgery can be done to remove the fibrous tissue and repair any small tendon tears. This may also help prevent an Achilles tendon rupture.

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.