What s The Big Cause Of Achilles Tendinitis Aches
Overview
The Achilles tendon, which connects the calf muscles to the heel bone, can withstand significant pressure from physical activities. Achilles tendinitis is estimated to account for approximately 11 percent of all running injuries, as the Achilles tendon provides the momentum to push off to walk or run. Achilles tendinitis, also called Achilles tendinopathy, results from overuse, injury or disease of the Achilles tendon, which causes the area to become inflamed. There are two types of Achilles tendinitis: Non-insertional Achilles Tendinitis - Fibers that are located in the middle portion of the tendon began to develop small tears that cause swelling and thickening. This type of tendinitis is usually found in younger people who are very active. Insertional Achilles Tendinitis - Develops where the tendon attaches to the heel bone in the lower part of the heel. Extra bone growth also called bone spurs form because of this tendinitis and can affect patients at any time, even if they are not active.
Causes
There are several factors that can contribute to achilles tendonitis. First, you should know that the biggest contributor to chronic achilles tendonitis is ignoring pain in your achilles tendon and running through the pain of early achilles tendonitis. If your achilles tendon is getting sore it is time to pay attention to it, immediately. Sudden increases in training can contribute to achilles tendonitis. Excessive hill running or a sudden addition of hills and speed work can also contribute to this problem. Two sole construction flaws can also aggravate achilles tendonitis. The first is a sole that is too stiff, especially at the ball of the foot. (In case you are having difficulty locating the "ball" of your foot, I mean the part where the toes join the foot and at which the foot bends) If this area is stiff than the "lever arm" of the foot is longer and the achilles tendon will be under increased tension and the calf muscles must work harder to lift the heel off the ground. The second contributing shoe design factor which may lead to continuing achilles tendon problem is excessive heel cushioning. Air filled heels, while supposedly are now more resistant to deformation and leaks are not good for a sore achilles tendon. The reason for this is quite simple. If you are wearing a shoe that is designed to give great heel shock absorption what frequently happens is that after heel contact, the heel continues to sink lower while the shoe is absorbing the shock. This further stretches the achilles tendon, at a time when the leg and body are moving forward over the foot. Change your shoes to one without this "feature". Of course another major factor is excessive tightness of the posterior leg muscles, the calf muscles and the hamstrings may contribute to prolonged achilles tendonitis. Gentle calf stretching should be performed preventatively. During a bout of acute achilles tendonitis, however, overly exuberant stretching should not be performed.
Symptoms
Achilles tendonitis typically starts off as a dull stiffness in the tendon, which gradually goes away as the area gets warmed up. It may get worse with faster running, uphill running, or when wearing spikes and other low-heeled running shoes. If you continue to train on it, the tendon will hurt more sharply and more often, eventually impeding your ability even to jog lightly. About two-thirds of Achilles tendonitis cases occur at the ?midpoint? of the tendon, a few inches above the heel. The rest are mostly cases of ?insertional? Achilles tendonitis, which occurs within an inch or so of the heelbone. Insertional Achilles tendonitis tends to be more difficult to get rid of, often because the bursa, a small fluid-filled sac right behind the tendon, can become irritated as well.
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
The recommended treatment for Achilles tendinitis consists of icing, gentle stretching, and modifying or limiting activity. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or aspirin, can reduce pain and swelling. Physical therapy and the use of an orthotic (heel lift) can also be helpful. For chronic cases where tendinosis is evident and other methods of treatment have failed, surgery may be recommended to remove and repair the damaged tissue.
Surgical Treatment
If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon.
Prevention
As with all injuries, prevention is your best defense especially with injuries that are as painful and inconvenient as Achilles tendonitis. Options for how to prevent Achilles tendonitis include, stretching- Stretching properly, starting slowly, and increasing gradually will be critical if you want to avoid Achilles tendonitis. To help maintain flexibility in the ankle joint, begin each day with a series of stretches and be certain to stretch prior to, and after, any exercise or excessive physical activity. Orthotics and Heel Support- Bio-mechanically engineered inserts and heel cups can be placed in your shoes to correct misalignments or bolster the support of your foot and are available without a prescription. The temporary heel padding that these provide reduces the length that the Achilles tendon stretches each time you step, making it more comfortable to go about your daily routine. Proper Footwear- Low-heeled shoes with good arch support and shock absorption are best for the health of your foot. Look into heel wedges and other shoe inserts to make sure that your everyday foot mechanics are operating under ideal conditions.