What is Achilles tendonitis?
Achilles tendonitis is a diseased state of the Achilles’ tendon, the tendon that connects the bone of the heel to a muscle called a calf. It is characterized by pains due to an inflammation caused by continuous and intense activities. Activities such as standing, walking, jumping, and all other activities that make use of the tendon can actually produce stress on it.
Two variants of Achilles tendonitis exist – insertional and non-insertional.
While the insertional variant affects the lower part of the tendon at its point of attachment to the heel bone, the non-insertional type affects the fibers found in the mid-region of the tendon. Non-insertional tendinitis is common with active young people.
This condition, irrespective of the variant can be treated with simple home remedies. But when all of the home remedies have failed, it is time to see a doctor. It could be an indication that it had got worse and needs a more aggressive approach to its treatment.
Photo Credit: Mind-Body Motion
Causes of Achilles tendonitis
Athletes are at a higher risk. You can develop Achilles tendonitis if you engage in too much exercise or walking. Other factors that can cause Achilles tendonitis are;
- Rheumatoid Arthritis.
- Activities repeatedly are undertaken: These can pose a strain on the tendon and its associated muscles. Such activities include exercising without an adequate warm-up, playing sports that require quick changes in direction (eg. tennis), a sharp increase in physical activities and not allowing your body to properly adjust to progressive training, putting on of old and poorly fitting covered shoes, the prolonged and consistent wearing of high heels, bone spurs in your heel’s back, old age.
Symptoms of Achilles tendonitis
Swellings of the heels and pains are the primary symptoms. Other secondary symptoms are discomforting swelling at the heel, tightened calf muscles, restricted feet motions during flexing, warm feelings at the heel when touched.
Diagnosis of Achilles tendonitis
Your doctor will take your medical history and ask a few questions about the pains and when it started. You will then be asked to stand on your feet’s ball while he observes your motion and flexibility range. The balls might have to be felt by your doctor so he could find out the part where you have the most swelling and pains.
He may go further to carry out confirmatory imaging tests such as X-rays, MRI scans, and or ultrasounds. Each of these tests has its distinct use. The X-rays will provide images of your leg and foot bones. The MRI scan will diagnose the presence of a rupture or degeneration of tissues. The ultrasound will make it possible for your tendon movements as well as the presence of damages and inflammation.
Treating Achilles tendonitis
Think of home remedies and think of rest and anti-inflammatory medications. Think of non-home remedies and think of invasive treatments such as surgery, platelet-rich plasma injections, and steroid injections.
More instructional treatment regimen you can expect to hear from your doctor include;
- Reduce your intense physical activities
- Learn to gently stretch and strengthen the muscles of your tendon
- Switch to a less body engaging sport
- Place ice on the affected area when it aches or after an exercise
- Raise your foot in order to reduce further swelling
- Wear a walking boot or a brace to help cushion heel movement.
- Get a physical therapy
- Take anti-inflammatory drugs like Bufferin (contains aspirin) or Advil (contains ibuprofen) for a short time.
- Wear built-up heel shoes to cushion your heels of tension
Another treatment method called RICE – rest, ice, compression, elevation
It is the most effective method right after an injury.
How to apply this treatment plan
Rest: avoid mounting pressure on your tendon 1-2 days until the pain on the tendon has stopped. If you follow this instruction, your tendon will heal faster.
In situations when you need to transit long distances, you might be asked to use crutches just for the tendon to rest enough for it to get healed.
Ice: It can drive inflammation and swell away very fast. Get some ice and put them in a bag. Get a cloth and wrap this bag in it. Now, place this wrapped cloth and place against the feet of your skin where the heel is. Let it remain on that spot for 15-20 minutes. You can take the wrapped ice off after this time to allow the tendon to regain warmth.
Compression: Compress the injury by tying a clothing article, wrapping an athletic tape or bandage around your tendon in such a way that it does not prevent blood flow around that area. This action reduces the swelling.
Elevation: Lie or sit down comfortably. Then raise your foot in such a way that it is above your chest. You can use a pillow as a support if you are lying down. What happens when you do this is that blood flows from your feet to the heart and as such the swelling is reduced.
Surgery comes to play when the Achilles tendon has to be repaired and prevented from a rupture when all treatments have failed. This alternative can cause sharp pains in the affected area.
An orthopedic surgeon will be recommended to do his by your doctor. There are two ways this surgical option can go. One, open repair. Two, close repair.
In open repair, your leg is opened above your heel bone and the two parts of the tear are sewn together. The leg is then closed up.
In close repair, the doctor opens the affected area through an incision. A suture needle is then passed through the tendon and brought forth. This back and forth suturing will eventually close the sutures up.
Complications of Achilles tendonitis
Pain, difficulty in walking, difficulty in exercising and deformed tendon and heel bone happen to be the most prevalent complications associated with this condition
Achilles tendon tear that might require a correctional surgery is also common. Hematoma and deep vein thrombosis according to documented studies often result after an Achilles tendonitis surgery.
A hematoma is associated with the formation of blood clots in tissues. Deep vein thrombosis is a state where blood becomes clotted in a deep vein. And these can worsen when more pressure is mounted on the heels after the surgery.
Recovery and outlook
It is just a matter of a few days if you take some time to rest as well as getting adequate home treatment. The RICE method of treatment is a good one to use, too. But if you fail to engage in good exercise habits or rest well, and keep mounting pressure on your heels, it will take a longer time. This is because a rupture may occur and could even have more injuries that will make the existing condition chronic. And when this happens, it might mean that a surgical procedure will be required to correct it by your doctor. It can take several weeks to heal.
Tendonitis that takes a long time to heel can precipitate into tendinosis or insertional tendonitis. In tendinosis, the tendon becomes very weak while in insertional tendonitis, the tendon inserts itself into the bone of the heel.
Whatever the case may be, seek your doctor’s assistance in any case of tendonitis for proper treatment and care. Follow the instructions you will be given by your doctor. Your quick recovery lies therein.
Preventing Achilles Tendonitis
In order to reduce your risk of developing Achilles tendonitis, cultivate the following habit:
- Stretching your calf muscles when you wake up every morning, prior to and after a workout. Doing these make the muscles less susceptible to an injury. It makes it more agile. How do you stretch it? Stand up. Ensure your legs are straight. Then keep the heel on the ground and lean forward
- Practice exercises that can intensify your physical activity.
- Combining high- and low-impact exercises to reduce the stress on your tendons. Examples include swimming and basketball.
- Go for shoes with comfortable and slightly raised heels and arch support.
- You could consider replacing your overworn old pairs of shoes. Arch supports could be fixed into them, too.
- If you are a lover of high heels shoes, gradually switch to flats so as to get your tendon to slowly adjust to the stress changes. It will also allow the tendons to its motion range.