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Complete Guide To Achilles Tendonitis

Achilles Tendonitis is an injury of the tendon, which is the tendon that connects the muscles of the calf to the heel bone. It is often seen in runners and some middle-aged people who play sports only on weekends. 

It is often diagnosed through some tests. Some of these tests include:

  • Calf squeeze test
  • X-ray.
  • MRI

These tests show the degree of damage you have, the type of tendon damage, and the type of treatment that would be suitable for you.

What Is Achilles Tendonitis

The Achilles tendon is the biggest in the body. It spans from the heel bones to the muscles of the calf. You can feel it if you stretch your legs – it is a spring-like band of tissue behind your ankle and right above your heel. It is what allows you to stand on tiptoe and allows you to point your toes in the direction of the floor.

Oftentimes, it is unavoidable for the tendon to get injured. The injuries might be mild and all you will feel is a slight burning sensation. It can also be chronic, in which the tendon may suffer a partial or complete tear.

Achilles tendonitis is one of the injuries that cause the tendons to be inflamed or swollen. There are two variants of this condition and they affect different parts of the condition. These include:

  • Noninsertional Achilles tendonitis: The fibers located in the middle of the tendons break down, get swollen and thicken.
  • Insertional Achilles tendonitis: This type of tendonitis often targets the lower part of the heel, which is the position where the tendons enter the heel bone. It can also result in bone spurs.

It is sometimes mistaken for Achilles tendinopathy, but the two ailments are different. Achilles tendinopathy is the damage and deterioration of collagen in the tendon. It often happens when Achilles tendonitis becomes severe.

Causes of Achilles Tendonitis

Excessive exercises or excessive walking are some of the common causes of Achilles tendonitis, especially for athletes. Nevertheless, other conditions can result in Achilles tendonitis. Rheumatoid Arthritis and infections can also cause tendonitis.

Activities that contain lots of repeated actions can also cause Achilles tendonitis. These activities include:

  • Running.
  • Gymnastics.
  • Dancing.
  • Football.
  • Baseball.
  • Softball.
  • Basketball.
  • Tennis.
  • Volleyball.

These injuries occur due to the sudden push-off or sudden start where you lift your foot and start moving. This is because the sudden action or movement might be too much for the tendon to take. You can also injure if you place a burden on it with high-impact workouts. These exercises are known as repetitive stress injuries.

Other causes of Achilles tendonitis include:

  • Starting an exercise without warming up.
  • Placing a burden on the muscles of the calf while performing repetitive exercises or activities.
  • Participating in sports like tennis, that consists of quick stops and swift changes of direction.
  • Abrupt upgrade of physical activities without giving the body time to adjust to the increase.
  • Putting on old or poorly fitting shoes.
  • Putting on heels daily or for long durations.
  • Bone spurs at the back of your heels.
  • Age – the Achilles tendon weakens with age.
  • Working out on rough surfaces.
  • Starting a new type of workout.

Symptoms of Achilles Tendonitis

The usual symptom of Achilles tendonitis includes pain above the heel, particularly when you attempt to stretch your ankles or try to stand on your toes. The pain may ease up or get worse over time. If the tendon ruptures, the pain is sudden and sharp and the affected area may get swollen, stiff, or tender.

If the Achilles tendon suffers a tear, it would give off a snapping or popping sound. It could also result in bruising and swelling which would make it difficult to point your toes downwards or walk on your toes.

Other symptoms include:

  • Pain, inflammation, or swelling in the back of the heel.
  • Tight calf muscles.
  • Inability to move your foot around a wide axis (limited range of motion).
  • Excessive warmness of the skin of the heel.
  • Weakness.
  • Discomfort around the heel.

You may also feel some discomfort in the back of your heel when you walk or run. The skin of your heel will also feel warm to the touch.

Achilles Tendonitis Relief

Mild Achilles tendonitis often heals on its own. However, to quicken the process, here are some ways to relieve the pain:

  • Rest your leg: Refrain from putting a lot of pressure on the leg as much as possible. If required, try using crutches.
  • Ice Therapy: Placing an ice pack on the injury for 20 minutes at a time would also help relieve the pain.
  • Compress your leg: You can make use of an elastic bandage to compress the lower leg and the ankle to reduce swelling.
  • Raise (Elevate) your leg: Place your leg on a pillow or any raised surface while laying down. Make sure your leg is placed above chest level.
  • Use Anti-inflammatory Painkillers: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can help lessen the discomfort and swelling. Endeavor to read the instructions on the pack to avoid certain side effects like bleeding and ulcers. Consume the drugs with food. Talk to your doctor before taking the drugs to avoid complications.
  • Use a heel lift: Your doctor might recommend wearing an insert in your shoes pending your recovery period. It will safeguard your Achilles tendon and prevent it from stretching further. 
  • Practice stretching and strengthening exercises: Your doctor or physical therapist might recommend some stretching and strengthening exercises for you. Practice them as recommended.

Achilles Tendonitis Stretches

If you are physically active and perform lots of workouts, you need to be mindful of Achilles tendon injuries. Although, it can withstand a lot of pressure from running and jumping, putting too much burden on it can result in a tear or rupture. Below are stretching exercises that are good for the tendon:

Calf Stretch: Position your hands on a wall with one leg straight and the heel firmly placed on the ground. Position the other leg, while bending the knee, in front of the straight leg and move your hips in the direction of the wall. Stretch your calf until you feel a strong pull but no discomfort. Make sure your heels remain on the ground. Remain in the position for 10 seconds, then ease up. Repeat 20 times on each foot slowly and steadily.

Sitting Heel Raises: Take a seat and elevate your toes as high as you can without pain. Gradually lower your heels. Do this 20 times a day. You can increase the difficulty by pressing down on your thighs or holding a weight on your thighs. 

Stretching tips

To get fast relief, you should stretch your Achilles tendon often. You should continue the stretches even after you have recovered, this will help to strengthen the tendons. To get the maximum result from the stretches, always remember the tips below:

  • Take your time.
  • Avoid bouncing and sudden movements.
  • Keep your heel down and firmly on the floor.
  • If you feel pain, stop immediately.

Achilles Tendonitis vs Achilles Tear

Achilles Tear

Achilles tear or Achilles’ tendon rupture is a partial or total disruption of the tendon right above the heel. This often results in an inability to lift the foot. 

Causes of Achilles tear include injuries and major trauma.

Symptoms of Achilles Tear include: 

  • Sudden popping or snapping sound in the heel.
  • Inability to walk properly after sustaining injuries.
  • Pain and discomfort near the heel.
  • Swelling and inflammation near the heel.

Treatments include stretching and strengthening exercises to boost the calf muscles, refraining from working out on rough, uneven, or slippery surfaces. Gradually increase of training sessions can also alleviate the pains of Achilles tear.

Achilles Tendonitis

Achilles tendonitis is an injury of the Achilles’ tendon, which is the connection between the calf muscles and the heel bones.

Causes of Achilles tendonitis include repetitive activities, bone spurs, poorly fitting shoes, working out on rough surfaces.

Symptoms of Achilles’ tendonitis include:

  • Heel pain.
  • Tenderness in the areas surrounding the heel.
  • Swelling and inflammation at the back of the heel.
  • Limited range of motions.

Treatments include:

  • Rest.
  • Ice pack.
  • Compression.
  • Elevation.

Achilles Tendonitis Treatment

Physical Therapy 

If you sustain injuries in your Achilles tendon, you may require physical therapy to enable a quick recovery. PT often includes exercises, workouts, stretches, and other activities to get you back in form. The duration you will spend in PT depends on how severe your injury is. A grade I injury may need 2-4 weeks of PT when compared with a grade III which would mean several months of PT. Some injuries require up to 6 months of PT before you can heal. During that time frame, you may be required to meet with your therapist once or twice a week.

Acupuncture

Treating Achilles Tendon with Acupuncture is a fast way to heal from injuries. Acupuncture helps to make the body stronger and repair damage to the tendons. It also aids in boosting anti-inflammatory responses and helps improve blood circulation to the tendons and all surrounding tissues. Acupuncture helps to kickstart some cellular processes that help tendons heal quicker and help them become stronger. Acupuncture also has precision which helps it treat the affected area accurately.

Surgery

In some rare cases, surgery might be required to treat the Achilles tendon. If the condition deteriorates and is left unchecked, it might result in an Achilles tear or rupture, which will require surgical treatment to heal. Your doctor might recommend a few options depending on how chronic your injury is. He might also recommend an orthopedic surgeon to know which process will be perfect for you. 

One of the surgical procedures is known as open repair. In this process, a surgeon makes an opening in your leg just above the heel bone. The two sides of the ruptured or torn tendon will be sewn back together and the opening is closed.

In the other method, a surgeon makes an opening on the point of the rupture. Needles with sutures are then passed through the tendon and the skin and then removed through the incision. Finally, the sutures are tied together.

Braces and Compression Sleeves

Your doctor might recommend the use of braces to support your Achilles tendon and prevent the injuries from happening again. 

Exercises for Achilles Tendonitis

Below are some exercises you can perform to heal Achilles Tendonitis:

  1. Seated heel raises

Seated heel raises helps to increase strength and give support to the Achilles’ tendon.

How To Perform

  • Sit on a chair or at the edge of a bed. Place your feet at a distance of shoulder width.
  • Raise your heels as high as you can, pause, then slowly lower them.
  • Finish one set of 20 to 25 reps. Repeat 5 or 6 every day.
  1. Standing heel raises

If you have the strength, you can do it while on your feet. This variation also uses the muscles that are attached to the Achilles’ tendon. 

How to perform

  • Stand while placing your feet at shoulder-width. Grab a chair for support.
  • Raise your heels and stand on the balls of your feet. Pause, then gradually bring your heels to the floor.
  • Finish one set of 20 or 25 reps. Repeat 5 or 6 times each day.

Other exercises include:

  • Resistance band calf exercise.
  • Toe-to-wall stretch.
  • Runner’s stretch.
  • Heel drop.

Natural Remedies for Achilles Tendonitis 

Below are some natural remedies for Achilles Tendonitis:

  • Reduce your physical activity.
  • Use an ointment to increase flexibility, mobility, and relieve discomfort. 
  • Strengthening and stretching exercises to aid the calf muscles in recovery.
  • Changing your physical activities to a less stressful sport.
  • Placing an ice pack on the affected area.
  • Raising the foot to reduce inflammation or swelling.
  • Physical therapy.
  • Using anti-inflammatory drugs such as aspirin or ibuprofen for a short period.
  • Get plenty of rest.

Achilles Tendonitis Prevention 

To lower the risk of Achilles tendonitis, take note of the following:

  • Stretch your muscles at the beginning of each new day to boost your agility and make your Achilles tendon resistant to injury. Ensure you stretch before and after workouts. To stretch your Achilles’ tendon, stand while keeping your leg straight, and lean forward while keeping your heel on the ground.
  • Start a new exercise routine, gradually increasing the intensity of your workout.
  • Make a combination of high- and low-impact exercises, for example, basketball and swimming. This will help reduce the regular pressure on your tendons.
  • Wear shoes that fit and have good cushioning and arch support. Do not wear a pair of shoes for long, change them if they are old.
  • Reduce the heel size of your shoes when moving from high heels to flats. This gives your tendon time to gradually stretch and increase its range of motion.
  • If you want to buy new shoes, make sure the heels are slightly raised to take the stress off your Achilles tendon. 
  • Refrain from uphill running.
  • Stop the exercise if you feel pain, discomfort, or tightness in the back of your heel or calf.
  • Do not work out on uneven surfaces.

Conclusion

If you discover you have Achilles tendonitis or other issues that affect the Achilles tendon, you can do stretching exercises to aid recovery. These exercises help you to improve movement by loosening the tension on the tendon.

Strengthening exercises can also help the calf and heel muscles and make them resistant to injuries. The stronger the muscles, the lesser it is prone to injuries. The stress on the tendons will also be reduced. 

Talk to your doctor before starting tendon stretches or exercises. While you are in the recovery stage, make sure you take lots of rest and reduce your activity.

If your Achilles tendon does not get better after exercise, try the R.I.C.E method. If it does not get better, do not hesitate to consult your doctor.

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