Achilles tendonitis is commonly seen in athletes who sustain an increase in training load, and is most often due to overuse. Tendons respond poorly to overuse, therefore
healing is slow. This can leave a tendon pathologically defective, which decreases tendon strength and leaves it less able to tolerate load, thus vulnerable to further injury or tendinosis. Extrinsic
factors contributing to this condition include training errors and inappropriate footwear. Intrinsic factors include inflexibility, weakness and malalignment. In other situations, there will be
clinical inflammation, but objective pathologic evidence for cellular inflammation is lacking, and in these conditions the term tendinosis is more appropriate. Tendinosis is a degeneration of the
tendon?s collagen in response to chronic overuse; when overuse is continued without giving the tendon time to heal and rest, such as with repetitive strain injury, tendinosis results. Even tiny
movements, such as clicking a mouse, can cause tendinosis, when done repeatedly.
Like any muscle or tendon in the body, the older we get, the more likely we are to sustain an injury. So middle-aged men and women are most at risk, with a slightly higher risk factor attributed to
males. Those who participate in more intense athletic activities like high impact sports (tennis, running, basketball) are most susceptible to the injury. Certain underlying medical conditions can
also be a contributing factor. Diabetics are more at risk of suffering from Achilles Tendinitis, as are those who are not in great physical shape. Some antibiotics, particularly fluoroquinolones can
make one more likely to suffer a strained Achilles Tendon.
Common symptoms of Achilles tendinitis include, 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 experienced a sudden
"pop" in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose an Achilles injury such as Achilles tendonitis. Occasionally, further investigations such as
an Ultrasound, X-ray or MRI scan may be required to assist with diagnosis and assess the severity of the condition.
There are a variety of treatments for Achilles tendonitis. These range from rest and aspirin to steroid injections and surgery. Your doctor might suggest, reducing your physical activity, stretching
and strengthening the calf muscles, switching to a different, less strenuous sport, icing the area after exercise or when in pain, raising your foot to decrease swelling, wearing a brace or
compressive elastic bandage to prevent heel movement, undergoing physical therapy, taking anti-inflammatory medication (e.g., aspirin or ibuprofen) for a limited time, getting steroid injections,
Sometimes more conservative treatments are not effective. In these cases, surgery may be necessary to repair the Achilles tendon. If the condition intensifies and is left untreated, there?s a greater
risk of an Achilles rupture. This can cause sharp pain in the heel area.
Surgery is considered the last resort. It is only recommended if all other treatment options have failed after at least six months. In this situation, badly damaged portions of the tendon may be
removed. If the tendon has ruptured, surgery is necessary to re-attach the tendon. Rehabilitation, including stretching and strength exercises, is started soon after the surgery. In most cases,
normal activities can be resumed after about 10 weeks. Return to competitive sport for some people may be delayed for about three to six months.
Suggestions to reduce your risk of Achilles tendonitis include, incorporate stretching into your warm-up and cool-down routines, maintain an adequate level of fitness for your sport, avoid dramatic
increases in sports training, if you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse, wear good quality supportive shoes
appropriate to your sport. If there is foot deformity or flattening, obtain orthoses, avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf
muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury, maintain a normal healthy weight.