Achilles tendinitis is an irritation/inflammation in the achilles tendon, which attaches to the back of the heel. It is often a result of overuse and occurs frequently in runners
who have altered their training suddenly, either with regard to duration or intensity. This injury is also prevalent in middle-aged people who are active.
Achilles tendonitis occurs in sports such as running, jumping, dancing and tennis. Other risk factors include participation in a new sporting activity or increasing the intensity of participation.
Poor running technique, excessive pronation of the foot and poorly fitting footwear may contribute. In cyclists, the problem may be a low saddle, which causes extra dorsiflexion of the ankle when
pedalling. Quinolone antibiotics (eg, ciprofloxacin, ofloxacin) can cause inflammation of tendons and predispose them to rupture.
Symptoms vary because you can injure various areas of the muscle-tendon complex. The pain may be an acute or chronic sharp, stabbing, piercing, shooting, burning or aching. It is often most
noticeable immediately after getting out of bed in the morning, or after periods of inactivity, like sitting down for lunch. After a couple minutes of walking around, it will often then settle down
somewhat, before becoming symptomatic again after excessive time standing or walking. But regardless of how the pain is perceived, Achilles tendon pain should not be left untreated due to the danger
that the tendon can become weak, frayed, thickened, and eventually it may rupture.
The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in
looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further
studies are necessary.
The first thing to do is to cut back your training. If you are working out twice a day, change to once a day and take one or two days off per week. If you are working out every day cut back to every
other day and decrease your mileage. Training modification is essential to treatment of this potentially long lasting problem. You should also cut back on hill work and speed work. Post running ice
may also help. Be sure to avoid excessive stretching. The first phase of healing should be accompanied by relative rest, which doesn't necessarily mean stopping running, but as I am emphasizing, a
cut back in training. If this does not help quickly, consider the use of a 1/4 inch heel lift can also help. Do not start worrying if you will become dependent on this, concentrate on getting rid of
the pain. Don't walk barefoot around your house, avoid excessively flat shoes, such as "sneakers", tennis shoes, cross trainers, etc. In office treatment would initially consist of the use of the
physical therapy modalities of electrical stimulation, (HVGS, high voltage galvanic stimulation), and ultrasound. Your sports medicine physician should also carefully check your shoes. A heel lift
can also be used and control of excessive pronation by taping can also be incorporated into a program of achilles tendonitis rehabilitation therapy. Orthotics with a small heel lift are often
Occasionally, conservative management of Achilles tendon conditions fails. This failure is more common in older male patients and those with longstanding symptoms, those who persist in full training
despite symptoms or those who have uncorrected predisposing factors. In these cases, surgery may be indicated. It should be remembered, however, that the rehabilitation program, particularly for
severe Achilles tendon injuries, is a slow, lengthy program. Surgery is only indicated when there is failure to progress in the rehabilitation program. Surgery should not be considered unless at
least six months of appropriate conservative management has failed to lead to improvement.
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.