The Achilles is a
large tendon that connects two major calf muscles to the back of the heel bone. If this tendon is overworked and tightens, the collagen fibres of the tendon may break, causing inflammation and pain.
This can result in scar tissue formation, a type of tissue that does not have the flexibility of tendon tissue. Four types of Achilles injuries exist, 1) Paratendonitis - involves a crackly or
crepitus feeling in the tissues surrounding the Achilles tendon. 2) Proliferative Tendinitis - the Achilles tendon thickens as a result of high tension placed on it. 3) Degenerative Tendinitis - a
chronic condition where the Achilles tendon is permanently damaged and does not regain its structure. 4) Enthesis - an inflammation at the point where the Achilles tendon inserts into the heel
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.
Pain anywhere along the tendon, but most often on or close to the heel. Swelling of the skin over the tendon, associated with warmth, redness and tenderness. Pain on rising up on the toes and pain
with pushing off on the toes. If you are unable to stand on your toes you may have ruptured the tendon. This requires urgent medical attention. A painful heel for the first few minutes of walking
after waking up in the morning. Stiffness of the ankle, which often improves with mild activity.
Your physiotherapist or sports doctor can usually confirm the diagnosis of Achilles tendonitis in the clinic. They will base their diagnosis on your history, symptom behaviour and clinical tests.
Achilles tendons will often have a painful and prominent lump within the tendon. Further investigations include US scan or MRI. X-rays are of little use in the diagnosis.
If caught early enough, simple physical therapy that you can do by yourself should be fine. Over the counter solutions as easy as pain medication, cold compresses, a different pair of shoes, or a new
set of stretching exercises can make most of the symptoms of Achilles tendinitis disappear. Further trouble or extreme pain should be regarded as a sign that something more serious is wrong, and you
should immediately consult a doctor or physician. They will look to see whether non-surgical or surgical methods are your best options, and from there you can determine what your budget is for
dealing with the condition.
In cases of severe, long-term Achilles tendonitis the sheath may become thick and fibrous. In these cases surgery may be recommended. Surgery aims to remove the fibrous tissue and repair any tears in
the tendon. A cast or splint will be required after the operation and a recovery program including physiotherapy, specific exercises and a gradual return to activity will be planned.
Achilles tendinitis cannot always be prevented but the following tips will help you reduce your risk. If you are new to a sport, gradually ramp up your activity level to your desired intensity and
duration. If you experience pain while exercising, stop. Avoid strenuous activity that puts excessive stress on your Achilles tendon. If you have a demanding workout planned, warm up slowly and
thoroughly. Always exercise in shoes that are in good condition and appropriate for your activity or sport. Be sure to stretch your calf muscles and Achilles tendon before and after working out. If
you suffer from Achilles tendinitis make sure you treat it properly and promptly. If self-care techniques don?t work, don?t delay. Book a consultation with a foot care expert or you may find yourself
sidelined from your favourite sports and activities.