Achilles Tendonitis Treatment
The Achilles tendon is a thick fibrous band of tissue that connects the heel to the calf muscles of the lower leg.
The muscles in the legs are the most powerful group of muscles in the body and the Achilles tendon is the thickest and strongest tendon in the body.
Contracting the calf muscles pulls the Achilles tendon, which pushes the foot downward- plantar flexion. This contraction permits a person to stand on the toes, walk, run, and jump. Each Achilles tendon is subjected to a person’s entire body weight with each step. Depending upon speed, stride, terrain and additional weight being carried or pushed, each Achilles tendon may be forced to carry up to 3-12 times a person’s body weight during a sprint or push off.
The most common Achilles tendon injuries are Achilles tendinosis, also known as Achilles tendonitis and Achilles tendon rupture.
Achilles tendonitis is one of the most common forms of ankle tendonitis.
Achilles tendinosis presents as a soreness and stiffness that comes on gradually and continues to worsen until treated. It often starts with stiffness and creaking when first getting out of bed in the morning. Pinching the Achilles tendon with the forefinger and thumb will reproduce soreness. The Achilles tendon can be sore along its entire length. It often is painful where it inserts into the calcaneus (insertional Achilles tendonitis). Achilles tendinosis is a common injury among middle and long distance runners. However, it may also come on in people who do alot of walking in bare feet or who have flat feet.
Achilles tendon rupture is a partial or complete tear of the Achilles tendon. It comes on suddenly, sometimes with a popping sound, and is debilitating. Partial and full Achilles tendon ruptures are most likely to occur in sports requiring sudden eccentric stretching, such as sprinting and racquet sports. Partial Achilles tendon tears are also common among middle and long distance runners. Achilles tendon ruptures are most likely to occur to middle age athletes who have not undergone proper training. It is sometimes difficult to distinguish between Achilles tendinosis and a partial Achilles tendon tear. Diagnostic tests such as diagnostic ultrasound or magnetic resonance imaging may be required.
The best Achilles tendonitis treatment is prevention. Stretching the Achilles tendon before exercise, even at the start of the day, will help to maintain flexibility in the ankle joint. Problems with foot mechanics can also be treated with devices inserted into the shoes. This is particularly true for the “weekend warrior.”
Proper footwear can be one of the keys to preventing, recovering from, and preventing the reoccurrence of, Achilles tendon injuries. Incorrect footwear can cause or exacerbate Achilles tendon injuries. Selecting the right shoe or sneaker in terms of cushioning, arch height, and pronation is always beneficial. Some people experience a tremendous temporary benefit from a little extra padding or cushioning under the heel. Elevation of the heel often provides instant relief.
The temporary heel padding reduces the length of Achilles tendon stretching made with each step or stride. Many find motion control (anti-pronation) shoes helpful. Others require custom made: shoe inserts (orthotics), shoes, or sport shoes – designed specifically for the unique requirements of an individual’s feet and activities. In extreme cases a brace may be required to immobilize an injured Achilles tendon.
Other conservative measures used to treat Achilles tendonitis include icing the injury, anti-inflammatory medications, and physical therapy.
Interest in tissue regenerative procedures such as tenotomy and platelet-derived growth factors have led to several observational studies showing the ability of this procedure to help and cure Achilles tendinosis.
Resting the painful Achilles tendon will allow reduction of inflammation and allow for healing. Therefore, crosstraining is an important aspect of recovery. Steroid injections are not used in the case of Achilles tendonitis because studies have shown an increased incidence of Achilles tendon rupture after steroid injections.
Achilles tendon rupture is generally treated surgically to reattach the tendon to its normal position. In some individuals, generally people who live sedentary lifestyles, surgery may be avoided by casting the Achilles tendon rupture for several months. However, the rate of re-rupture is much higher in the non-surgical patients. In patients who have surgery for an Achilles tendon rupture, less than 3% experience a re-rupture of the tendon.