The Achilles tendon is the thickest and strongest tendon in your body, connecting your calf muscles to the back of your heel. Virtually all of the force generated when you ?toe off? the ground during running is transmitted by the Achilles, and this force can be as much as three times your body weight. And the faster you run, the more strain you put on the Achilles tendon. As such, it?s prone to injury in many runners, but particularly those who do a lot of fast training, uphill running, or use a forefoot-striking style. Achilles tendon injuries account for 5-12% of all running injuries, and occur disproportionately in men. This may be because of the faster absolute speeds men tend to train at, or may be due to other biomechanical factors.
Over-pronation, injury and overstresses of the tendon are some of the most common causes. Risk factors include tight heel cords, poor foot alignment, and recent changes in activities or shoes. During a normal gait cycle, the upper and lower leg rotate in unison (i.e. internally during pronation and externally during supination). However, when a person over-pronates, the lower leg is locked into the foot and therefore continues to rotate internally past the end of the contact phase while the femur begins to rotate externally at the beginning of midstance. The Gastrocnemius muscle is attached to the upper leg and rotates externally while the Soleus muscle is attached to the lower leg and rotates internally during pronation. The resulting counter rotation of the upper and lower leg causes a shearing force to occur in the Achilles tendon. This counter rotation twists the tendon at its weakest area, namely the Achilles tendon itself, and causes the inflammation. Since the tendon is avascular, once inflammation sets in, it tends to be chronic.
The main symptom of Achilles tendonitis is a feeling of pain and swelling in your heel as you walk or run. Other symptoms include tight calf muscles and limited range of motion when flexing the foot. This condition can also make the skin in your heel feel overly warm to the touch.
If Achilles tendonitis is suspected, avoid any exercise or activity that causes the pain. It is advisable to see a doctor promptly so that an accurate diagnosis can be made and appropriate treatment recommended. The doctor will take a full medical history and will ask about the nature and duration of the symptoms. They will perform a physical examination of the affected area. Ultrasound scanning may be used to assess damage to the tendon or surrounding structures. Occasionally MRI (magnetic resonance imaging) may be recommended. The symptoms of Achilles tendonitis are often similar to symptoms of other conditions such as partial Achilles tendon rupture and heel bursitis. This can make diagnosis difficult and a referral to an orthopaedic specialist may be required in order for an accurate diagnosis to be made.
Use the R.I.C.E method of treatment when you first notice the pain. Although rest is a key part of treating tendonitis, prolonged inactivity can cause stiffness in your joints. Move the injured ankle through its full range of motion and perform gentle calf and ankle stretches to maintain flexibility. If self-care doesn’t work, it’s important to get the injury treated because if the tendon continues to sustain small tears through movement, it can rupture under excessive stress. Your doctor may suggest a temporary foot insert that elevates your heel and may relieve strain on the tendon. Other possible treatments include special heel pads or cups to wear in your shoes to cushion and support your heel, or a splint to wear at night. Physical therapy may also help allow the tendon to heal and repair itself over a period of weeks.
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.
You can take measures to reduce your risk of developing Achilles Tendinitis. This includes, Increasing your activity level gradually, choosing your shoes carefully, daily stretching and doing exercises to strengthen your calf muscles. As well, applying a small amount ZAX?s Original Heelspur Cream onto your Achilles tendon before and after exercise.