Achilles tendinitis (tendonitis) or Achilles tendon inflammation occurs when the Achilles tendon becomes inflamed, as a result, of the Achilles tendon being put under too
much strain. The Achilles tendon joins the calf muscles to the heel bone, and is found at the back of a person's lower leg. It is the largest tendon in the body and can endure great force, but is
still susceptible to injury. Achilles tendinitis is usually the result of strenuous, high impact exercise, such as running. If ignored, Achilles tendinitis can lead to the tendon tearing or
rupturing, and therefore it is important to seek the necessary treatment. Sometimes, treatment can be as simple as getting rest or changing an exercise routine. However, in more severe cases, surgery
may be required.
The calf is under a lot of strain when running: it is not only put on stretch during landing of the foot, but it also has to produce the tension needed to support body weight and absorb the shock of
landing. This is what is called an ?eccentric load?. Excessive eccentric loading - either by way of a dramatic increase in mileage, or excessive hill running, or faulty running posture - could very
well be the cause of a runner?s achilles tendinitis. The calf strain translates downward into the achilles tendon where it attaches to the heel, and inflammation ensues. Inflammation then causes
scarring and fibrosis of tissues, which in turn inflicts pain upon stretching or use. Risk factors for Achilles tendinitis also include spending prolonged amounts of time standing or walking.
Most cases of Achilles tendonitis start out slowly, with very little pain, and then grow worse over time. Some of the more common symptoms include mild pain or an ache above the heel and in the lower
leg, especially after running or doing other physical activities, pain that gets worse when walking uphill, climbing stairs, or taking part in intense or prolonged exercise, stiffness and tenderness
in the heel, especially in the morning, that gradually goes away, swelling or hard knots of tissue in the Achilles tendon, a creaking or crackling sound when moving the ankle or pressing on the
Achilles tendon, weakness in the affected leg.
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.
Treatment depends on severity of pain. The most effective long-term treatment for Achilles tendinitis/tendinopathy is physical therapy, particularly therapy that focuses on eccentric muscle/tendon
strengthening. Calf and Achilles stretching are also an important part of the treatment. In severe cases, treatment may begin with a period of rest and immobilization in order to calm down the tendon
before physical therapy is initiated. Anti-inflammatories may be prescribed. Avoiding activities that aggravate the Achilles tendon will help the healing process. Improvement and resolution of
symptoms can take months. Exercise might be the cause of Achilles tendonitis, but it can also help prevent it and aid in recovery. Healing will occur more quickly if there is no pressure on the
injured tendon, and if the foot is at least partially immobilized.
If several months of more-conservative treatments don't work or if the tendon has torn, your doctor may suggest surgery to repair your Achilles tendon.
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.