ACHILLES TENDONITIS (TENDONOSIS)

Definition: Achilles Tendinitis or Tendinosis is a painful degenerative, overuse syndrome of the thickest and strongest tendon in the human body. The Achilles tendon attaches the calf muscle (gastrocnemius and soleus) to the back of the heel bone (calcaneus).

Function: The Achilles Tendon is responsible for plantar flexion (same movement that occurs when you point your foot) and therefore important for activities such as walking, running, jumping, climbing.

Mechanism of Injury

The Achilles tendon is prone to injury because it is used in all weight bearing activities and in many sports. Micro tearing of the tendon often results from intensive repetitive activities especially which are predominantly eccentric in nature. The Achilles tendon also does not have a good blood supply, so injury can be slow to heal.

Signs & Symptoms

  • Pain at the attachment point (insertion) at the back of the heel, or in the mid-portion of the tendon (approx 1.5 cm above the heel)
  • Gradual development of symptoms include: pain that occurs in the tendon or insertion while exercising or a couple of hours after, morning stiffness and pain with increased activity level
  • Swelling or formations of a bump at back of heel or thickening within tendon, as well as some Achilles tendons 'creak' when touched or moved.

Causes

  • Can be caused by sudden increase in training volume or intensity/overuse
  • Lack of flexibility or improper stretching prior to injury
  • Decreased strength or endurance
  • Flat or high arched feet
  • Excessive hill running
  • Improper/overworn footwear
  • Drastic change in footwear heel height
  • Pedorthic Treatments

Custom made Orthotics are one of the most effective methods to reduce your symptoms and pain. They are able to redistribute and load the foot in a different way in order to decrease the stress put onto the ankle bones and long arches. Pedorthists use interventions such as a deep heel cups, and a stabilizing arch support. Proper footwear is just as important as the orthotic to recovery. Talk to your Pedorthist about proper footwear choices for you.

Other Treatment

STRETCHING: calf stretch HEAT/ICE: 10- 15 minutes to relieve pain and reduce swelling.
OTHER TREATMENT may include pain medication, physiotherapy, massage therapy, dorsi-flexion night splint.

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