You can feel your
Achilles tendon beneath the skin on the back of your ankle. It is a fibrous band of tissue that connects your calf muscles to your heel bone (calcaneus), which allows you to lift your heel off the
ground. Most commonly an overuse injury, the term Achilles tendinitis commonly refers to, acute inflammation in the sheath surrounding your tendon, chronic damage to the tendon itself, called
tendinosis, a combination of the two. Achilles tendinitis can range from mild inflammation to, in rare cases, a tendon rupture. One type of tendinitis, called insertional Achilles tendinitis, can
affect the end of the tendon where it attaches to your heel bone. Achilles tendinitis also can be associated with other foot problems, such as painful flat feet.
Some of the causes of Achilles tendonitis / tendinosis include. Overuse injury - this occurs when the Achilles tendon is stressed until it develops small tears. Runners seem to be the most
susceptible. People who play sports that involve jumping, such as basketball, are also at increased risk. Arthritis - Achilles tendonitis can be a part of generalised inflammatory arthritis, such as
ankylosing spondylitis or psoriatic arthritis. In these conditions both tendons can be affected. Foot problems - some people with over pronated feet (Flat Feet) or feet that turn inward while walking
are prone to Achilles tendonitis. The flattened arch pulls on calf muscles and keeps the Achilles tendon under tight strain. This constant mechanical stress on the heel and tendon can cause
inflammation, pain and swelling of the tendon. Being overweight can make the problem worse. Footwear - wearing shoes with minimal support while walking or running can increase the risk, as can
wearing high heels. Overweight and obesity - being overweight places more strain on many parts of the body, including the Achilles tendon.
Symptoms include pain in the heel and along the tendon when walking or running. The area may feel painful and stiff in the morning. The tendon may be painful to touch or move. The area may be swollen
and warm. You may have trouble standing up on one toe.
To confirm the diagnosis and consider what might be causing the problem, it?s important to see your doctor or a physiotherapist. Methods used to make a diagnosis may include, medical history,
including your exercise habits and footwear, physical examination, especially examining for thickness and tenderness of the Achilles tendon, tests that may include an x-ray of the foot, ultrasound
and occasionally blood tests (to test for an inflammatory condition), and an MRI scan of the tendon.
The best treatment for Achilles tendonitis is preventative, stretching and warming up properly before starting an activity. Proper rest, accompanied by stretching and icing to reduce swelling, can
help to heal an overworked Achilles tendon. Placing an adequate heel lift in both shoes will allow the heel to have contact with the ground without placing stress on the Achilles tendon. Wear a tie
shoe that is stiff soled and has a wide base, then add an over-the-counter or custom foot orthosis inside the shoe to prevent the twisting motion of the Achilles tendon due to over pronation. In the
event that the tendon is unable to heal due to your life style or activity, you may have to be put in a walking cast for a short period to give it a chance to heal. You need to have the doctor,
physical therapist, or come in to our facility to check for a leg length difference due to the walking cast being higher. This is to prevent any discomfort to the hips. After the tendon has healed
and before the foot is taken out of the walking cast, range of motion at the ankle must be tested and if the foot is not allowed to properly bend upwards 15 degrees then the tightness in the calf
will cause the foot to over pronate and reinjure. A stretching program will be needed to loosen up the calf muscle before much weight bearing is done without the cast. The stretching program can be
found at the menu for feet hurt. If necessary a heel lift can be put in both shoes to help take the stress off the tendon. Should the tightness of the calves be the primary cause for the Achilles
tendon damage and stretching has not loosen the Achilles tendon sufficiently, then discussion with your doctor for a calf release may have to be considered.
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.
By properly training the body, an athlete can build the strength of their tendons and muscles. Following a workout and dieting plan, the body will be able to build muscle and strengthen most
effectively. Additionally, doing the following can prevent tendinitis. Wearing appropriate shoes will give your foot the support it needs for proper movements of the foot and ankle. Improper
movements will put additional stress on your body. Stretching before an athletic activity, Stretching primes the body for a taxing activity. Additionally, this will get your blood flowing and reduce
the risk of pulling a muscle. Ask your doctor about orthotics, Custom orthotics can help get your foot into proper alignment. If the foot does not execute proper mechanics, the body will adjust which
will cause pain and increase the chances of injury.