Achilles tendinitis can be a
very crippling issue for runners - simply because the pain is enough to discourage loading of the foot. It can also be a tricky condition to treat because the tendon is not as heavily vascularized
(i.e. more blood flow) as muscle, and therefore lacks healing potential. It is highly recommended that you see a physical therapist as soon as you experience acute symptoms, so chronic tendonosis
(which is longer termed and harder to treat) does not set in.
Achilles tendinitis can be caused by any activity that puts stress on your Achilles tendon. Tendinitis can develop if you run or jump more than usual or exercise on a hard surface. Tendinitis can be
caused by shoes that do not fit or support your foot and ankle. Tight tendons and muscles, You may have tight hamstring and calf muscles in your upper and lower leg. Your tendons also become stiffer
and easier to injure as you get older. Arthritis, Bony growths caused by arthritis can irritate the Achilles tendon, especially around your heel.
Symptoms of Achilles Tendinitis include the following. Pain and stiffness along the Achilles tendon in the morning. Pain along the tendon or back of the heel that worsens with activity. Severe pain
the day after exercising. Thickening of the tendon. Bone spur (insertional tendinitis). Swelling that is present all the time and gets worse throughout the day with activity. If you have an Achilles
tendon rupture, you might feel a pop or snap, accompanied by a sharp pain behind your ankle. You are likely to have difficulty walking properly. If you have ruptured your Achilles tendon then surgery
is likely to be the best treatment option.
When diagnosing Achilles tendinitis, a doctor will ask the patient a few questions about their symptoms and then perform a physical examination. To perform a physical exam on the Achilles tendon, the
doctor will lightly touch around the back of the ankle and tendon to locate the source of the pain or inflammation. They will also test the foot and ankle to see if their range of motion and
flexibility has been impaired. The doctor might also order an imaging test to be done on the tendon. This will aid in the elimination of other possible causes of pain and swelling, and may help the
doctor assess the level of damage (if any) that has been done to the tendon. Types of imaging tests that could be used for diagnosing Achilles tendinitis are MRI (Magnetic resonance imaging), X-ray,
If caught early enough, simple physical therapy that you can do by yourself should be fine. Over the counter solutions as easy as pain medication, cold compresses, a different pair of shoes, or a new
set of stretching exercises can make most of the symptoms of Achilles tendinitis disappear. Further trouble or extreme pain should be regarded as a sign that something more serious is wrong, and you
should immediately consult a doctor or physician. They will look to see whether non-surgical or surgical methods are your best options, and from there you can determine what your budget is for
dealing with the condition.
Surgical treatment for tendons that fail to respond to conservative treatment can involve several procedures, all of which are designed to irritate the tendon and initiate a chemically mediated
healing response. These procedures range from more simple procedures such as percutaneous tenotomy61 to open procedures and removal of tendon pathology. Percutaneous tenotomy resulted in 75% of
patients reporting good or excellent results after 18 months. Open surgery for Achilles tendinopathy has shown that the outcomes are better for those tendons without a focal lesion compared with
those with a focal area of tendinopathy.62 At 7 months after surgery, 67% had returned to physical activity, 88% from the no-lesion group and 50% from the group with a focal lesion.
Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the
following precautions. Getting a variety of exercise - alternating between high-impact exercises (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the
Achilles tendon is under less tension. Limit certain exercises - doing too much hill running, for example, can put excessive strain on the Achilles tendon. Wearing the correct shoes and replacing
them when worn - making sure they support the arch and protect the heel will create less tension in the tendon. Using arch supports inside the shoe, if the shoe is in good condition but doesn't
provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely. Stretching, doing this before and after exercising helps to keep the
Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility. Gradually
increasing the intensity of a workout - Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your
muscles time to loosen up and puts less pressure on the tendon.