What s The Main Cause Of Achilles Tendinitis

Overview
Achilles tendinitis is an inflammation of your Achilles tendon. It?s quite common in people who have psoriatic arthritis, reactive arthritis or ankylosing spondylitis. It can also occur as an over-use injury in people who take part in excessive exercise or exercise that they?re not used to.

Causes
Unusual use or overuse of the lower leg muscles and Achilles tendon is usually the cause of Achilles tendinitis. Repetitive jumping, kicking, and sprinting can lead to Achilles tendinitis in both recreational and competitive athletes. Runners, dancers, and athletes over age 65 are especially at risk. Sudden increases in training or competition can also inflame your Achilles tendon. For example, adding hills, stair-climbing, or sprinting to your running workout puts extra stress on your Achilles tendon. Improper technique during training can also strain the tendon. Intense running or jumping without stretching and strengthening your lower leg muscles can put you at risk regardless of your age or fitness level. Running on tight, exhausted, or fatigued calf muscles can put added stress on your Achilles tendon, as your tendon may not be ready to quickly start a workout after a period of inactivity. Direct blows or other injuries to the ankle, foot, or lower leg may pull your Achilles tendon too far and stretch the tissue. A hard contraction of the calf muscles, such as can happen when you push for the final sprint in a race, can strain the tendon. People whose feet roll inward, a condition called overpronation, are particularly at risk. Sometimes, shoes with too much heel cushioning put extra strain on the Achilles tendon.

Symptoms
There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.

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
Achilles tendinitis can typically be treated at home by following the R.I.C.E. treatment method. Rest. Rest the tendon by avoiding activities that irritate the tendon or increase swelling. However, this does not mean you should be completely inactive for long periods of time, as this can cause stiffness in your joints. It?s still important to stretch in order to maintain strength and flexibility and partake in activities that don?t put direct pressure on the tendon, such as bicycling. Ice. Apply ice to the affected area for 20-minutes at a time, every couple hours, as needed, to reduce swelling and pain. Compression. Use compression bandages to help reduce swelling. Elevation. Elevate your ankle above the level of your heart to help reduce swelling. It is particularly important to do this at night while you sleep. Simply place a pillow or two under your ankle to keep it elevated. Once the tendon has healed, be sure to gradually return to more strenuous activities. If flattened arches contributed to the injury, wear shoes with appropriate support or inserts to prevent the condition from progressing or recurring. If these non-surgical treatments have not been able to provide relief of symptoms after several months, surgery may be performed to remove inflamed tissue. However, this is not usually recommended unless all other options have been exhausted. Consult your doctor for more information about surgical treatment options.


Surgical Treatment
Surgery is considered the last resort. It is only recommended if all other treatment options have failed after at least six months. In this situation, badly damaged portions of the tendon may be removed. If the tendon has ruptured, surgery is necessary to re-attach the tendon. Rehabilitation, including stretching and strength exercises, is started soon after the surgery. In most cases, normal activities can be resumed after about 10 weeks. Return to competitive sport for some people may be delayed for about three to six months.

Prevention
The following measures can significantly reduce the risk of developing Achilles tendonitis. Adequately stretch and warm up prior to exercise. Warm down and stretch after exercise. Choose footwear carefully and use footwear appropriate to the sport being undertaken. Use orthotic devices in footwear to correctly support the foot. Exercise within fitness levels and follow a sensible exercise programme. Develop strong, flexible calf muscles.