What Are The Most Obvious Main Treatment And Cause Of Achilles Tendon Pain ?

Overview

Achilles TendonitisAchilles tendonitis is an inflammation of the Achilles tendon, which attaches the calf muscles (gastrocnemius and soleus) to the heel bone (calcaneus). Pain can be felt on the back of the heel at the attachment of the tendon, along the length of the tendon, or at the base of the calf where the tendon attaches to the muscle. Swelling is not always present with this injury, but it may occur in severe cases.

Causes

Possible factors leading to the development of Achilles tendonitis include the following. Implementing a new exercise regiment such as running uphill or climbing stairs. Change in exercise routine, boosting intensity or increasing duration. Shoes worn during exercise lack support, either because the soles are worn out or poor shoe design. Omitting proper warm-up prior to strenuous exercise. Running on a hard or uneven surface. Deformation in foot such as a flat arch, or any anatomic variation that puts unnecessary strain on the Achilles tendon.

Symptoms

Achilles tendonitis is an injury that occurs when your Achilles tendon -- the large band of tissues connecting the muscles in the back of your lower leg to your heel bone -- becomes inflamed or irritated. The signs and symptoms of Achilles tendonitis often develop gradually. You'll feel pain and stiffness in your Achilles, especially when you first get out of bed. The pain lessens as you warm up, and may even disappear as you continue running. Once you stop, the pain returns and may feel even worse. You may also notice a crackling or creaking sound when you touch or move your Achilles tendon.

Diagnosis

Examination of the achilles tendon is inspection for muscle atrophy, swelling, asymmetry, joint effusions and erythema. Atrophy is an important clue to the duration of the tendinopathy and it is often present with chronic conditions. Swelling, asymmetry and erythema in pathologic tendons are often observed in the examination. Joint effusions are uncommon with tendinopathy and suggest the possibility of intra-articular pathology. Range of motion testing, strength and flexibility are often limited on the side of the tendinopathy. Palpation tends to elicit well-localized tenderness that is similar in quality and location to the pain experienced during activity. Physical examinations of the Achilles tendon often reveals palpable nodules and thickening. Anatomic deformities, such as forefoot and heel varus and excessive pes planus or foot pronation, should receive special attention. These anatomic deformities are often associated with this problem. In case extra research is wanted, an echography is the first choice of examination when there is a suspicion of tendinosis. Imaging studies are not necessary to diagnose achilles tendonitis, but may be useful with differential diagnosis. Ultrasound is the imaging modality of first choice as it provides a clear indication of tendon width, changes of water content within the tendon and collagen integrity, as well as bursal swelling. MRI may be indicated if diagnosis is unclear or symptoms are atypical. MRI may show increased signal within the Achilles.

Nonsurgical Treatment

Many physical therapies exist to help with the pain. We have found the combination of modalities, stretching, acupuncture, footwear modification and myofascial release to be very effective. In resilient cases, a promising new treatment called Radial Shockwave may be indicated. The key to the treatment of this, and other foot problems, is an accurate diagnosis. With this, a treatment regimen tailored to you and your specific situation can be devised. We treat many acute and chronic achilles tendinitis in Edmonton and St. Albert, so remember ?it shouldn?t hurt.?

Achilles Tendonitis

Surgical Treatment

Surgery for an acute Achilles tendon tear is seemingly straightforward. The ends of the torn tendon are surgically exposed and sutures are used to tie the ends together. The sutures used to tie together the torn tendon ends are thick and strong, and are woven into the Achilles both above and below the tear. While the concepts of surgery are straightforward, the execution is more complex. Care must be taken to ensure the tendon is repaired with the proper tension -- not too tight or too loose. The skin must be taken care of, as excessive handling of the soft tissues can cause severe problems including infection and skin necrosis. Nerves are located just adjacent to the tendon, and must be protected to prevent nerve injury. If surgery is decided upon, it is usually performed within days or weeks of the injury. The idea is to perform the repair before scar tissue has formed, which would make the repair more difficult. Some surgeons may recommend delaying surgery a few days from the initial injury to allow swelling to subside before proceeding with the repair.

Prevention

Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.

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