Achilles tendinitis is a common condition that causes pain on the back of the leg near the heel. The achilles tendon is the largest tendon in the body connecting your calf
muscles to your heel bone. Your achilles tendon is used when you walk, run or jump. It is made to withstand a high amount of stress from these activities, but when it is overused, you can develop
tendinitis. Tendinitis is defined as inflammation of a tendon. When you are injured, your body's natural response causes inflammation. You may experience pain, swelling, or tenderness at the injured
site. There are two types of achilles tendinitis, insertional and non-insertional achilles tendinitis.
There are a number of ways a person can develop Achilles tendinitis. Some causes are easier to avoid than others, but being aware of them can aid earlier diagnosis and help prevent serious injury.
Causes of Achilles tendinitis include, using incorrect or worn out shoes when running or exercising. Not warming up properly before exercise. Increasing intensity of exercise too quickly (e.g.
running speed or distance covered). Prematurely introducing hill running or stair climbing to exercise routine. Running on hard or uneven surfaces. Calf muscle is injured or has little flexibility
(this puts a lot of strain on the Achilles tendon). Sudden intense physical activity such as sprinting for the finish line. Achilles tendinitis can also be caused by differences in foot, leg or ankle
anatomy. For example, some people can have flatness in their foot where there would normally be an arch; this puts more strain on the tendon. The FDA has asked that a boxed warning be added to the
prescribing information for fluoroquinolone antibiotics. Patients taking these drugs may experience an increased risk of tendinitis and tendon rupture. Fluoroquinolones include Cipro (ciprofloxacin),
Factive (gemifloxacin), Levaquin (levofloxacin), Avelox (moxifloxacin), Noroxin (norfloxacin), Floxin (ofloxacin) and Proquin (ciprofloxacin hydrochloride). It is important to remember that the risk
for injury is not necessarily gone when the drug is stopped. Cases have been reported in which tendon problems occurred up to several months after the drug was discontinued.
Symptoms of Achilles Tendinitis include the following. Pain and stiffness along the Achilles tendon in the morning. Pain along the tendon or back of the heel that worsens with activity. Severe pain
the day after exercising. Thickening of the tendon. Bone spur (insertional tendinitis). Swelling that is present all the time and gets worse throughout the day with activity. If you have an Achilles
tendon rupture, you might feel a pop or snap, accompanied by a sharp pain behind your ankle. You are likely to have difficulty walking properly. If you have ruptured your Achilles tendon then surgery
is likely to be the best treatment option.
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.
Take a course (5 - 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist. Apply ice to the Achilles - for 10
minutes every 2 hours, in order to reduce the inflammation. Avoid weight-bearing activities and keep foot elevated where possible. Self-massage - using arnica oil or anti-inflammatory gel. Rub in
semi-circles in all directions away from the knotted tissue, three times a day once the nodule is gone, stretch the calf muscle gently do not start running until you can do heel raises and jumping
exercises without pain return to running gradually full recovery is usually between six to eight weeks.
There are three common procedures that doctor preform in order help heal the tendinitis depending on the location of the tendinitis and amount of damage to the tendon, including: Gastrocnemius
recession - With this surgery doctors lengthen the calf muscles because the tight muscles increases stress on the Achilles tendon. The procedure is typically done on people who have difficulty
flexing their feet even with constant stretching. Debridement and Repair - When there is less than 50% damage in the tendon, it is possible for doctors to remove the injured parts and repair the
healthy portions. This surgery is most done for patients who are suffering from bone spurs or arthritis. To repair the tendon doctors may use metal or plastic anchors to help hold the Achilles tendon
in place. Patients have to wear a boot or cast for 2 weeks or more, depending and the damage done to the tendon. Debridement with Tendon Transfer - When there is more the 50% damage done to the
Achilles tendon, and Achilles tendon transfer is preformed because the remain healthy tissue is not strong enough. The tendon that helps the big toe move is attached to give added strength to the
damaged Achilles. After surgery, most patients don?t notice any difference when they walk or run.
Wear shoes that fit correctly and support your feet: Replace your running or exercise shoes before the padding or shock absorption wears out. Shock absorption greatly decreases as the treads on the
bottoms or sides of your shoes begin to wear down. You may need running shoes that give your foot more heel or arch support. You may need shoe inserts to keep your foot from rolling inward. Stretch
before you exercise: Always warm up your muscles and stretch gently before you exercise. Do cool down exercises when you are finished. This will loosen your muscles and decrease stress on your
Achilles tendon. Exercise the right way: If your tendinitis is caused by the way that you exercise, ask a trainer, coach, or your caregiver for help. They can teach you ways to train or exercise to
help prevent Achilles tendinitis. Do not run or exercise on uneven or hard surfaces. Instead, run on softer surfaces such as treadmills, rubber tracks, grass, or evenly packed dirt tracks.