The Achilles tendon is
the largest and strongest tendon in the human body. It is the ?cord? in the back of the leg that inserts into the back of the heel. The Achilles tendon got its name, according to Greek legend, when
the Greek warrior, Achilles, was dipped into the River Styx by Thetis, his mother. This rendered him invincible with the exception of his unsubmerged heel. Unfortunately, he went on to get mortally
wounded during the siege of Troy when he was struck in that heel by an arrow. Achilles tendinitis is inflammation and partial tearing of the Achilles tendon. It can occur with overuse of the tendon
such as when starting or increasing the intensity of an exercise program or performing impact loading activities that include a lot of running and/or jumping.
Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon, but
other factors can make it more likely to develop tendinitis, including a bone spur that has developed where the tendon attaches to the heel bone, Sudden increase in the amount or intensity of
exercise activity-for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance, Tight calf muscles, Having tight calf muscles
and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon, Bone spur-Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the
tendon and cause pain.
Symptoms of acute achilles tendonitis will be a gradual onset of achilles pain at the back of the ankle, just above the heel bone. This may develop over a period of days. The achilles tendon may be
painful and stiff at the start of exercise and first thing in the morning. As the tendon warms up the pain will go often for it to return later in the day or towards the end of a prolonged training
session. The tendon will be very tender on palpation or pressing in on the achilles tendon or squeezing it from the sides. Chronic achilles tendonitis may follow on from acute achilles tendonitis if
it goes untreated or is not allowed sufficient rest. Chronic achilles tendonitis is a difficult condition to treat, particularly in older athletes who appear to suffer more often.
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.
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.
The type of surgery you will have depends on the type of injury you are faced with. The longer you have waited to have surgery will also be a factor that determines what type of surgery is needed.
With acute (recent) tearing the separation in your Achilles tendon is likely to be very minimal. If you have an acute tear you may qualify for less invasive surgery (such as a mini-open procedure).
Surgeons will always choose a shorter, less invasive procedure if it is possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the tendon and a much quicker
rate of recovery after the surgery.
The following measures can significantly reduce the risk of developing Achilles tendonitis. Adequately stretch and warm up prior to exercise. Warm down and stretch after exercise. Choose footwear
carefully and use footwear appropriate to the sport being undertaken. Use orthotic devices in footwear to correctly support the foot. Exercise within fitness levels and follow a sensible exercise
programme. Develop strong, flexible calf muscles.