tendon connects the calf muscle to the back of the heel. Injuries to the Achilles tendon are common, as it is in constant use during walking and running. These injuries, known as Achilles tendinitis,
are usually the result of overuse damage and minor tears that have accumulated over years. Your risk of developing Achilles tendinitis increases with age and activity level. Many athletes develop
Achilles tendinitis. The tendon may be injured several inches away from where it attaches to the foot or at the point of attachment. An injury at the point of attachment is called Achilles
enthesopathy. We recommend a combination of treatments over a period of months that may include wearing supportive shoes or orthotic devices, performing stretching exercises, and icing the affected
area. If these treatments are not effective, or if the tendon is completely torn, we may recommend surgery.
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.
People with achilles tendinitis experience mild aching on the back of the leg close to the heel after increased activity. Stiffness in the back of the ankle when you first wake up in the morning,
which subsides after mild activity. In some cases, the area may have swelling, thickening or be warm to the touch. Tenderness to touch along the tendon in the back of the ankle. Pain when the tendon
is stretched (i.e. when you lift your foot/toes up).
A doctor or professional therapist will confirm a diagnosis, identify and correct possible causes, apply treatment and prescribe eccentric rehabilitation exercises. An MRI or Ultrasound scan can
determine the extent of the injury and indicate a precise diagnosis. Gait analysis along with a physical assessment will identify any possible biomechanical factors such as over pronation which may
have contributed to the achilles tendonitis and training methods will be considered. Biomechanical problems can be corrected with the use of orthotic inserts and selection of correct footwear.
Treatment for achilles tendonitis is based around initially reducing pain and inflammation, stretching the muscles out and a gradual return to activity. No one single approach may cure achilles
tendonitis, particularly a chronic condition but a combination of treatment approaches and patience will work best. It is essential the correct treatment is started as soon as possible in the acute
stage to avoid the injury becoming chronic. Acute achilles tendonitis requires rest. Continuing to train on a painful achilles tendon could lead to the injury becoming chronic and more difficult to
treat. Applying ice or cold therapy as soon as possible to a painful achilles tendon will reduce pain and inflammation. After the first 24 to 48 hours alternating hot and cold or just heat may be
more beneficial. Tendons work better when they are warm but if they are painful then rest and ice. Wear a heel pad to raise the heel and shorten the calf muscles which in turn reduces some of the
strain on the achilles tendon. This should only be a temporary measure while the achilles tendon is healing. An achilles tendon taping technique can aid rest by supporting the tendon with elastic
bandages. This is an excellent way of taking the load off the tendon if you have to walk around on your feet as well as protecting the tendon when returning to full fitness. Achilles tendon
exercisesMake sure you have the right running shoes for your foot type and the sport. If you are a runner that over-pronates then a motion control or support running shoe may be needed. Visit a
specialist running shop for advice. In the later stages apply heat, especially before exercise. The tendon will perform better when warm. Finish with cold after training to reduce any
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.
Stay in good shape year-round and try to keep your muscles as strong as they can be. Strong, flexible muscles work more efficiently and put less stress on your tendon. Increase the intensity and
length of your exercise sessions gradually. This is especially important if you've been inactive for a while or you're new to a sport. Always warm up before you go for a run or play a sport. If your
muscles are tight, your Achilles tendons have to work harder to compensate. Stretch it out. Stretch your legs, especially your calves, hamstrings, quadriceps, and thigh muscles - these muscles help
stabilize your knee while running. Get shoes that fit properly and are designed for your sport. If you're a jogger, go to a running specialty store and have a trained professional help you select
shoes that match your foot type and offer plenty of support. Replace your shoes before they become worn out. Try to run on softer surfaces like grass, dirt trails, or synthetic tracks. Hard surfaces
like concrete or asphalt can put extra pressure on the joints. Also avoid running up or down hills as much as possible. Vary your exercise routine. Work different muscle groups to keep yourself in
good overall shape and keep individual muscles from getting overused. If you notice any symptoms of Achilles tendonitis, stop running or doing activities that put stress on your feet. Wait until all
the pain is gone or you have been cleared to start participating again by a doctor.