Which are the Primary Treatment And Cause Of Achilles Tendinitis Pains

Overview
Typically an overuse injury, Achilles tendinitis affects the connective tissue between the calf and the heel. When you walk, run or otherwise use your leg to push your body upward, the Achilles tendon is engaged. Using the tendon frequently and with high intensity often results in tendinitis -- a swollen Achilles tendon that makes it difficult and sometimes painful to continue high-impact activities.

Causes
Possible factors leading to the development of Achilles tendonitis include the following. Implementing a new exercise regiment such as running uphill or climbing stairs. Change in exercise routine, boosting intensity or increasing duration. Shoes worn during exercise lack support, either because the soles are worn out or poor shoe design. Omitting proper warm-up prior to strenuous exercise. Running on a hard or uneven surface. Deformation in foot such as a flat arch, or any anatomic variation that puts unnecessary strain on the Achilles tendon.

Symptoms
The main complaint associated with Achilles tendonitis is pain behind the heel. The pain is often most prominent in an area about 2-4 centimeters above where the tendon attaches to the heel. In this location, called the watershed zone of the tendon, the blood supply to the tendon makes this area particularly susceptible. Patients with Achilles tendonitis usually experience the most significant pain after periods of inactivity. Therefore patients tend to experience pain after first walking in the morning and when getting up after sitting for long periods of time. Patients will also experience pain while participating in activities, such as when running or jumping. Achilles tendonitis pain associated with exercise is most significant when pushing off or jumping.

Diagnosis
If you think you might have Achilles tendonitis, check in with your doctor before it gets any worse. Your doc will ask about the activities you've been doing and will examine your leg, foot, ankle, and knee for range of motion. If your pain is more severe, the doctor may also make sure you haven't ruptured (torn) your Achilles tendon. To check this, the doc might have you lie face down and bend your knee while he or she presses on your calf muscles to see if your foot flexes. Any flexing of the foot means the tendon is at least partly intact. It's possible that the doctor might also order an X-ray or MRI scan of your foot and leg to check for fractures, partial tears of the tendon, or signs of a condition that might get worse. Foot and ankle pain also might be a sign of other overuse injuries that can cause foot and heel pain, like plantar fasciitis and Sever's disease. If you also have any problems like these, they also need to be treated.

Nonsurgical Treatment
Treatment will depend on the severity of the injury. In general terms, the longer the symptoms are present before treatment begins, the longer the timeframe until complete recovery is achieved. Complete recovery can take between three and nine months. Initial treatment of Achilles tendonitis includes, Rest, to avoid further injury to the area. Ice, to reduce inflammation, Elevation, to reduce swelling. Bandaging or strapping, to support the area and restrict movement of the tendon. Anti-inflammatory medications to reduce pain and inflammation. (Cortisone (steroid) injections to reduce inflammation are not usually recommended as they may weaken the tendon and increase the risk of rupture). Other treatments include, Physiotherapy, Physiotherapy plays an important role in the treatment of Achilles tendonitis. This generally focuses on two main areas - treatment and rehabilitation. Treatment may involve such techniques as massage, ultrasound, acupuncture and gentle stretching. Rehabilitation involves the development of an individualised recovery programme, the most important aspect of which is strengthening. Strengthening of the muscles surrounding the Achilles tendon helps to promote healing in the tendon itself. Strengthening is achieved through the use of specific exercises, which will be taught by the physiotherapist. One such exercise is eccentric loading, which involves contracting the calf muscle while it is being stretched. It is common for the rehabilitation programme to take up to three months. Podiatry, including gait analysis and the fitting of orthotic devices to support the foot and reduce stress on the tendon, may be recommended. For cases of Achilles tendonitis that do not respond to initial treatment, casting or splinting of the affected foot may be recommended to allow it to rest completely.


Surgical Treatment
Surgery is an option of last resort. However, if friction between the tendon and its covering sheath makes the sheath thick and fibrous, surgery to remove the fibrous tissue and repair any tears may be the best treatment option.

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.