tendonitis is an iInflammation in the tendon of the calf muscle, where it attaches to the heel bone. Achilles tendonitis causes pain and stiffness at the back of the leg, near the heel. Achilles
tendonitis can be caused by overuse of the Achilles tendon, overly tight calf muscles or Achilles tendons, excess uphill running, a sudden increase in the intensity of training or the type of shoes
worn to run, or wearing high heels at work and then switching to a lower-heeled workout shoe. Achilles tendonitis causes pain, tenderness, and often swelling over the Achilles tendon. There is pain
on rising up on the toes and pain with stretching of the tendon. The range of motion of the ankle may be limited. Treatment includes applying ice packs to the Achilles tendon, raising the lower leg,
and taking an anti-inflammatory medication. In some severe cases of Achilles tendonitis, a cast may be needed for several weeks. A heel lift insert may also be used in shoes to prevent future
overstretching of the Achilles tendon. Exerting rapid stress on the Achilles tendon when it is inflamed can result in rupture of the tendon.
Excessive exercise is a common cause of Achilles tendonitis. This is particularly true for athletes. However, factors unrelated to exercise may also contribute to risk. Rheumatoid arthritis and
infection are both correlated with tendonitis. In general, any repeated activity that strains the Achilles tendon can contribute to this problem. Here are a few possible causes, jumping into an
exercise routine without a proper warm-up, straining calf muscles during repeated exercise or physical activity, playing sports such as tennis that require quick stops and changes of direction,
wearing old or ill-fitting shoes, wearing high heels every day.
People with Achilles tendinitis may experience pain during and after exercising. Running and jumping activities become painful and difficult. Symptoms include stiffness and pain in the back of the
ankle when pushing off the ball of the foot. For patients with chronic tendinitis (longer than six weeks), x-rays may reveal calcification (hardening of the tissue) in the tendon. Chronic tendinitis
can result in a breakdown of the tendon, or tendinosis, which weakens the tendon and may cause a rupture.
To confirm the diagnosis and consider what might be causing the problem, it?s important to see your doctor or a physiotherapist. Methods used to make a diagnosis may include, medical history,
including your exercise habits and footwear, physical examination, especially examining for thickness and tenderness of the Achilles tendon, tests that may include an x-ray of the foot, ultrasound
and occasionally blood tests (to test for an inflammatory condition), and an MRI scan of the tendon.
Initial treatment consists of medication and ice to relieve the pain, stretching and strengthening exercises, and modification of the activity that initially caused the problem. These all can be
carried out at home, although referral to a physical therapist or athletic trainer for further evaluation and treatment may be helpful. Occasionally a walking boot or cast may be recommended to
immobilize the tendon, allowing the inflammation to settle down. For less severe cases or after immobilization, a heel lift may be prescribed to reduce stress to the tendon. This may be followed by
an elastic bandage wrap of the ankle and Achilles tendon. Orthotics (arch supports) may be prescribed or recommended by your physician. Surgery to remove the inflamed tendon lining or degenerated
tendon tissue is rarely necessary and has shown less than predictable results.
Treating this surgically, there are numerous methods to repair the tendon. Most commonly, Achilles tendon is exposed through an incision at the back of the ankle. After identifying both ends of
ruptured tendon, the edges got trimmed and then both ends were sutured together with optimal tension. To get a better outcome with fixation, an anchor may have to be in place in calcaneus, provided
the rupture is very low. Care must be taken to avoid injuries to the nerves located adjacent to the tendon.
If you're just getting started with your training, be sure to stretch after running, and start slowly, increasing your mileage by no more than 10% per week. Strengthen your calf muscles with
exercises such as toe raises. Work low-impact cross-training activities, such as cycling and swimming, into your training.