Achilles Tendonitis
Most professional or amateur sportsmen have at some time felt pain or stiffness in the back of their ankle. Often this pain is hard to take too seriously because as soon as they start moving around whether it be just walking or doing some form of other exercise the pain seems to disappear. But what is causing that nagging pain?
What is Achilles Tendonitis?
AT is actually an overuse injury causing pain on the achilles tendon. If you are a keen runner there is a very good chance that at some point you will suffer from AT. The achilles tendon is the thick, strong tendon at the back of the ankle. It can be difficult to cure and it is important the correct treatment is followed. It connects the large calf muscles to the heel bone and provides the power in the push off phase of the gait cycle (walking and running). AT is often referred to in medical terms as achilles tendinopathy. This is because the term tendinopathy covers all types of overuse achilles tendon injury. Huge forces are transmitted through the achilles tendon when running and jumping. AT can be either acute, meaning occurring over a period of a few days, following an increase in training, or chronic which occurs over a longer period of time. In addition to being either chronic or acute, the condition can also be either at the attachment point to the heel or in the mid-portion of the tendon (typically around 4cm above the heel). Healing of the achilles tendon is often slow, due to its poor blood supply.
AT Symptoms
Acute AT
A gradual onset of achilles pain at the back of the ankle, just above the heel bone. This may develop over a period of days.
Achilles tendon pain at the start of exercise which fades as the exercise progresses and the tendon gets warmed up. The pain may later return if the training session is prolonged. The pain eases with rest but is often worse again in the morning when you take your first steps. The achilles tendon will be very tender on palpation or pressing in on the achilles tendon or squeezing it from the sides.
Chronic AT may follow on from acute AT if it goes untreated or is not allowed sufficient rest. Chronic AT is a difficult condition to treat, particularly in older athletes who appear to suffer more often.
Chronic AT
A gradual onset of achilles tendon pain over a period of weeks, or even months. Pain will come on during exercise and is constant throughout. Pain will be felt in the achilles tendon when walking especially up hill or up stairs. This is because the achilles is having to stretch further than normal.
There is likely to be stiffness in the Achilles tendon especially in the morning or after a long period of rest. This is thought to be due to adhesions between the tendon sheath and the tendon itself. There may be nodules or lumps in the achilles tendon, particularly 2-4cm above the heel. There may be redness over the skin. Again there will be tenderness on palpation or pressing in on the achilles tendon. As well as a swelling or thickening over the Achilles tendon.
AT Treatment
Rest and applying ice or cold therapy as soon as possible will reduce pain and inflammation. Rest is vital to allow healing to take place. Wear a heel pad to raise the heel and take some of the strain off the achilles tendon. This should only be a temporary measure while the achilles tendon is healing. Do not walk around in bare feet or flat shoes or pumps. Trainers are much better as the raised heel takes some strain of achilles tendon.
A taping technique can aid rest by supporting the tendon with elastic bandages. This is an excellent way of taking the load off the tendon if you have to walk around on your feet as well as protecting the tendon when returning to full fitness.
Make sure you have the right training shoes for your foot type and the sport. If you are a runner that over-pronates then a motion control or support running shoe may be needed. Visit a specialist running shop for advice.
In the later stages apply heat, especially before exercise. The tendon will perform better when warm. Finish with cold after training to reduce any inflammation.
See a sports injury professional asap. They can advise on treatment and rehabilitation plus give suitable treatment to work, stretch and mobilize the affected tissue.Ultra sound therapy maybe used to try and increase the blood supply to the affected area.
Use hydrotherapy to exercise achilles tendon. Gentle bouncing and running in the water works the ankle joint with natural resistance from the water. If you look after this injury early enough you should make a good recovery. It is important you rehabilitate the tendon properly after it has recovered or the injury will return. If you ignore the early warning signs and do not look after this injury then it may become chronic which is very difficult to treat.
