Just What Causes Tendonitis Ache In The Achilles

Overview
Inflammation of the Achilles tendon.The Achilles is the large tendon connecting the two major calf muscles, gastrocnemius and soleus, to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (that is tendinitis), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.

Causes
The calf is under a lot of strain when running: it is not only put on stretch during landing of the foot, but it also has to produce the tension needed to support body weight and absorb the shock of landing. This is what is called an ?eccentric load?. Excessive eccentric loading - either by way of a dramatic increase in mileage, or excessive hill running, or faulty running posture - could very well be the cause of a runner?s achilles tendinitis. The calf strain translates downward into the achilles tendon where it attaches to the heel, and inflammation ensues. Inflammation then causes scarring and fibrosis of tissues, which in turn inflicts pain upon stretching or use. Risk factors for Achilles tendinitis also include spending prolonged amounts of time standing or walking.

Symptoms
Recurring localized pain, sometimes severe, along the tendon during or a few hours after running. Morning tenderness about an inch and a half above the point where the Achilles tendon is attached to the heel bone. Sluggishness in your leg. Mild or severe swelling. Stiffness that generally diminishes as the tendon warms up with use.

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
Physical therapy is the first and most useful defense for achilles tendonitis because of the two presentations outlined above. Treatments for the two types are quite different in approach. Midsubstance tendinitis responds well to stretching, whereas insertional tendnitis tends to be aggravated more by it. Depend on your trusted physical therapist to differentiate between the two and follow their guidelines on exercises and running modifications. Running gait patterns that show excessive ?sinking postures? tend to point to the source of achilles tendon problems. Altering your gait in the midstance phase of the cycle can reduce the load on the tendon dramatically and thereby reduce pain. Rely on your running physical therapist for proper guidance on altering your gait the right way. Stride Strong?s Portland Running Clinic gait analysis can identify and fix potential issues before pain sets in. Icing at the onset of acute achilles pain (i.e. when the injury is fresh and new) would help control the inflammation. Your next step should be to call our number for an appointment.


Surgical Treatment
When the tendon tears or ruptures the variety of surgical techniques are available to repair the damage and restore the tendons function. Recent research that is done at Emory University Department of orthopedics have perfected the repair of the Achilles tendon. The procedure is generally involves making an incision in the back of your leg and stitching the torn tendon together using a technique developed and tested by Dr. Labib. Depending on the condition of the torn tissue the repair may be reinforced with other tendons.

Prevention
To lower your risk of Achilles tendonitis, stretch your calf muscles. Stretching at the beginning of each day will improve your agility and make you less prone to injury. You should also try to stretch both before and after workouts. To stretch your Achilles, stand with a straight leg, and lean forward as you keep your heel on the ground. If this is painful, be sure to check with a doctor. It is always a good idea to talk to your doctor before starting a new exercise routine. Whenever you begin a new fitness regimen, it is a good idea to set incremental goals. Gradually intensifying your physical activity is less likely to cause injury. Limiting sudden movements that jolt the heels and calves also helps to reduce the risk of Achilles tendonitis. Try combining both high- and low-impact exercises in your workouts to reduce stress on the tendon. For example, playing basketball can be combined with swimming. It doesn?t matter if you?re walking, running, or just hanging out. To decrease pressure on your calves and Achilles tendon, it?s important to always wear the right shoes. That means choosing shoes with proper cushioning and arch support. If you?ve worn a pair of shoes for a long time, consider replacing them or using arch supports. Some women feel pain in the Achilles tendon when switching from high heels to flats. Daily wearing of high heels can both tighten and shorten the Achilles tendon. Wearing flats causes additional bending in the foot. This can be painful for the high-heel wearer who is not accustomed to the resulting flexion. One effective strategy is to reduce the heel size of shoes gradually. This allows the tendon to slowly stretch and increase its range of motion.