What Can We Do About Achilles Tendonitis Discomfort

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Overview
Achilles tendinitis is an overuse injury common in many sports that require lots of running and jumping. Once this condition becomes more chronic adhesions that form along the tissues and the injury becomes more of a tendinosis. Treatment for a tendinosis is much different that for a tendinitis, so it is important to recognize What is a heel lift? stage the injury is at in order to treat it appropriately. An acute achilles tendinitis involves inflammation and would be treated with rest, ice, etc. Once the inflammation has decreased, research shows that eccentric exercises are beneficial. Once there is tendinosis, it becomes imperative to break up those adhesions with ART and prescribe appropriate stretches and exercises.

Causes
In some cases, Achilles Tendinitis can be caused by physical activity without a proper warm up or trauma, such as falling, to cause an overstressing of the muscle and tendon. Other causes include repetitive overuse syndrome, such as a job that required frequent heel lifting. Biomechanical causes such as pronation (or fallen arches) will cause the heel (calcaneus) to lean slightly, putting the undue stress on the Achilles tendon and the calf muscles. Most pain can be felt at the back of the heel or the point at which the calf muscle becomes a tendon three quarters of the distance down from the knee. Discomfort can be felt especially when jumping or when lifting the heel off the ground. Swelling and redness can often be seen at the back of the heel and touching the area would cause a tender sensation. In extreme cases, the tendon can become torn or rupture entirely which would cause bruising or an inability to put pressure on the foot.

Symptoms
The Achilles tendon is a strong muscle and is not usually damaged by one specific injury. Tendinitis develops from repetitive stress, sudden increase or intensity of exercise activity, tight calf muscles, or a bone spur that rubs against the tendon. Common signs and symptoms of Achilles Tendinitis include, gradual onset of pain at the back of the ankle which may develop in several days up to several months to become bothersome. Heel pain during physical activities which may diminish after warming up in early stages, or become a constant problem if the problem becomes chronic. Stiffness at the back of the ankle in the morning. During inactivity, pain eases. Swelling or thickening of the Achilles tendon. Painful sensation if the Achilles tendon is palpated. If a pop is heard suddenly, then there is an increased chance that the Achilles tendon has been torn and immediate medical attention is needed.

Diagnosis
To diagnose the condition correctly, your doctor will ask you a few questions about the pain and swelling in your heel. You may be asked to stand on the balls of your feet while your doctor observes your range of motion and flexibility. The doctor may also touch the area directly. This allows him to pinpoint where the pain and swelling is most severe.

Nonsurgical Treatment
Ask your Pharmacist for advice. 1) Your Pharmacy stocks a range of cold packs which may be applied to the area to decrease inflammation. 2) Ask your Pharmacist about a temporary heel raise or pad which can be inserted into footwear to decrease the force absorbed by the tendon when the feet land heavily on the ground. 3) Gently massaging a heat-producing liniment into the calf can help to relieve tension in the muscle which may relieve the symptoms of Achilles Tendinitis. Ask your Pharmacist to recommend the most appropriate type. 4) Gels, sprays or creams which help to reduce inflammation are available and may be applied to the injured area. Ask your Pharmacist for advice. 5) Your Pharmacist can advise you on analgesic, anti-inflammatory medications such as Aspirin which may be of assistance. Aspirin should be avoided in children under the age of 12 and those aged 12 to 15 who have a fever. 6) Strapping the ankle can help restrict movement and minimise further injury. Your Pharmacist stocks a range of athletic strapping tape and ankle guards which may assist your injury.


Surgical Treatment
Mini-Open Achilles Tendon Repair. During a mini-open Achilles tendon repair surgery, 2 to 8 small stab incisions are made to pull the edges of the tendon tear together and suture the torn edges to repair the damage. During this procedure the surgeon will make one 3 to 4 cm long incision on the back of your ankle and 2 to 4 smaller vertical incisions around the long incision. These smaller veritical incisions are made with a pair of surgical scissors and are commonly referred to as "stab incisions". Once the incisions are opened up, the surgeon will place precise sutures with non-absorbable stitches to strengthen the damaged Achilles tendon tissue. This suturing technique reduces the amount of scar tissue on the tendon after surgery and provides better surface healing of the skin. Unlike the traditional method of an open surgery, this procedure has less risks and complications involved. To learn about all risks you may face be sure to speak to your doctor.

Prevention
Although Achilles tendinitis cannot be completely prevented, the risk of developing it can be lowered. Being aware of the possible causes does help, but the risk can be greatly reduced by taking the following precautions. Getting a variety of exercise - alternating between high-impact exercises (e.g. running) and low-impact exercise (e.g. swimming) can help, as it means there are days when the Achilles tendon is under less tension. Limit certain exercises - doing too much hill running, for example, can put excessive strain on the Achilles tendon. Wearing the correct shoes and replacing them when worn - making sure they support the arch and protect the heel will create less tension in the tendon. Using arch supports inside the shoe, if the shoe is in good condition but doesn't provide the required arch support this is a cheaper (and possibly more effective) alternative to replacing the shoe completely. Stretching, doing this before and after exercising helps to keep the Achilles tendon flexible, which means less chance of tendinitis developing. There is no harm in stretching every day (even on days of rest), as this will only further improve flexibility. Gradually increasing the intensity of a workout - Achilles tendinitis can occur when the tendon is suddenly put under too much strain, warming up and increasing the level of activity gradually gives your muscles time to loosen up and puts less pressure on the tendon.