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March 04 2015

richardabsalon

Treatment And Cause Of Achilles Tendon Pain

Overview

Achilles TendinitisTendinitis is the inflammation of a tendon. Tendons are thick cords of tissue that connect muscles to bone. Achilles tendinitis, or an inflammation of the Achilles tendon, is one of the most common causes of foot or ankle pain. Other types of foot/ankle tendinitis include posterior tibial tendinitis and peroneal tendinitis.

Causes

Achilles tendinitis can be caused by overly tight calf muscles, excessive running up hill or down hill, a sudden increase in the amount of exercise, e.g. running for a longer distance, wearing ill-fitting running shoes, such as those with soles that are too stiff, or wearing high heels regularly, or changing between high heels all day and flat shoes or low running shoes in the evening. Overuse is common in walkers, runners, dancers and other athletes who do a lot of jumping and sudden starts/stops, which exert a lot of stress on the Achilles tendon. Continuing to stress an inflamed Achilles tendon can cause rupture of the tendon - it snaps, often with a distinctive popping sound. A ruptured Achilles tendon makes it virtually impossible to walk. An Achilles tendon rupture is usually treated by surgical repair or wearing a cast.

Symptoms

The pain associated with Achilles tendinitis typically begins as a mild ache in the back of the leg or above the heel after running or other sports activity. Episodes of more severe pain may occur after prolonged running, stair climbing or sprinting. You might also experience tenderness or stiffness, especially in the morning, which usually improves with mild activity. If you experience persistent pain around the Achilles tendon, call your doctor. Seek immediate medical attention if the pain or disability is severe. You may have a torn (ruptured) Achilles tendon.

Diagnosis

During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range of motion and reflexes of your foot and ankle. Your doctor may order one or more of the following tests to assess your condition, X-rays. While X-rays can't visualize soft tissues such as tendons, they may help rule out other conditions that can cause similar symptoms. Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images of the Achilles tendon in motion. Magnetic resonance imaging (MRI). Using radio waves and a very strong magnet, MRI machines can produce very detailed images of the Achilles tendon.

Nonsurgical Treatment

Wear shoes with a low half-inch to one-inch heel that are somewhat flexible through the ball of the foot. Avoid flat footwear such as slippers or sandals and stiff shoes. Add a heel lift in your shoe. You may also use arch support inserts or orthotic insoles. Heel lifts and orthotics can be purchased at many of our pharmacies and Podiatry departments. Avoid standing or walking barefoot. Perform calf-stretching exercises for 30 to 60 seconds on each leg at least 2 times a day. Stand an arm?s length away from a wall, facing the wall. Lean into the wall, stepping forward with one leg, leaving the other stretched behind you. The leg behind you is the one being stretched. Keep this leg straight (locked) and the toes pointed straight at the wall. Stretch forward until you feel tightness in the calf of your back leg. Hold this position without bouncing for 30 to 60 seconds. Repeat for the opposite leg. Do stair exercises every day. Stand facing the stairs with the ball of your foot on a stair and your heel hanging off. Balance on one foot at a time while holding onto the rail. Slowly lower your heel as low as it will drop down and then slowly raise it up as high as you can lift it. Repeat this exercise slowly several times on each foot. Perform this exercise every other day, gradually increasing the number of repetitions over time as tolerated. If you are overweight, talk to your personal physician about resources that can help you lose weight. Carrying excess weight places additional pressure on your feet. Decrease the time that you stand, walk, or engage in exercises that put a load on your feet. Switch to a nonimpact form of exercise until your tendon heals, such as swimming, pool running, and using an elliptical trainer.

Achilles Tendonitis

Surgical Treatment

The type of surgery you will have depends on the type of injury you are faced with. The longer you have waited to have surgery will also be a factor that determines what type of surgery is needed. With acute (recent) tearing the separation in your Achilles tendon is likely to be very minimal. If you have an acute tear you may qualify for less invasive surgery (such as a mini-open procedure). Surgeons will always choose a shorter, less invasive procedure if it is possible to do so. Most surgeons know that a less complicated procedure will have less trauma to the tendon and a much quicker rate of recovery after the surgery.

Prevention

A 2014 study looked at the effect of using foot orthotics on the Achilles tendon. The researchers found that running with foot orthotics resulted in a significant decrease in Achilles tendon load compared to running without orthotics. This study indicates that foot orthoses may act to reduce the incidence of chronic Achilles tendon pathologies in runners by reducing stress on the Achilles tendon1. Orthotics seem to reduce load on the Achilles tendon by reducing excessive pronation,

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