tendinitis is inflammation of the Achilles tendon, the fibrous tissue that connects the heel to the calf muscles. This condition is often caused by irritation of the tendon and typically affects
those who play sports. However, older individuals who suffer from arthritis may also be affected. Achilles tendinitis is typically the first stage of an Achilles tendon injury and should be treated
right away. Without treatment, the tendon can tear or rupture, which may require surgery.
When you place a large amount of stress on your Achilles tendon too quickly, it can become inflamed from tiny tears that occur during the activity. Achilles tendonitis is often a result of
overtraining, or doing too much too soon. Excessive hill running can contribute to it. Flattening of the arch of your foot can place you at increased risk of developing Achilles tendonitis because of
the extra stress placed on your Achilles tendon when walking or running.
Signs and symptoms of Achilles Tendinitis generally include pain and stiffness along your achilles tendon, especially in the morning. Pain in the back of your heel that gets worse with activity.
Severe pain the day after exercising. Swelling that gets worse with activity. If you feel a pop in the back of your heel or bottom of you calf, you may have ruptured or torn you achilles
The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes. X-rays can help diagnose bone problems.
An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.
As with most soft tissue injuries the initial treatment is RICE - Rest, Ice, Compression and Elevation. In the early phase you?ll be unable to walk without a limp, so your Achilles tendon needs some
active rest from weight-bearing loads. You may need to be non or partial-weight-bearing, utilise crutches, a wedged achilles walking boot or heel wedges to temporarily relieve some of the pressure on
the Achilles tendon. Your physiotherapist will advise you on what they feel is best for you. Ice is a simple and effective modality to reduce your pain and swelling. Please apply for 20-30 minutes
each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot. Anti-inflammatory medication (if tolerated) and natural substances eg arnica may help reduce your pain
and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain
reducing medication. As you improve a kinesio style supportive taping will help to both support the injured soft tissue.
Following the MRI or ultrasound scan of the Achilles tendon the extent of the degenerative change would have been defined. The two main types of operation for Achilles tendinosis are either a
stripping of the outer sheath (paratenon) and longitudinal incisions into the tendon (known as a debridement) or a major excision of large portions of the tendon, the defects thus created then being
reconstructed using either allograft (donor tendon, such as Wright medical graft jacket) or more commonly using a flexor hallucis longus tendon transfer. In cases of Achilles tendonosis with more
minor degrees of degenerative change the areas can be stimulated to repair itself by incising the tendon, in the line of the fibres, which stimulates an ingrowth of blood vessels and results in the
healing response. With severe Achilles tendonosis, occasionally a large area of painful tendon needs to be excised which then produces a defect which requires filling. This is best done by
transferring the flexor hallucis longus muscle belly and tendon, which lies adjacent to the Achilles tendon. This results in a composite/double tendon after the operation, with little deficit from
the transferred tendon.
Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining 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.