March 16th, 2012

Health N' Sports: Achilles Tendinitis

Staff Report


Health N' Sports: Achilles Tendinitis
photo from b4tea.com

Louisville Orthopaedic Clinic shares insight on the injury

As a part of the Louisville Orthopaedic Clinic, the Sports Rehab Team physical therapists are knowledgeable and trained in the latest advancements and techniques available in sports rehabilitation. On a weekly basis, the Health N’ Sports Update will give information on prevention, recovery, and include special offers, as well as general health tips that would be beneficial to all. If there is a specific topic you’d like to know or hear more about, email future suggestions to editor@catholicsportsnet.com.

Anatomy

The Achilles tendon attaches the two calf muscles, the gastrocnemius and the soleus, to the heel bone. It is a long tendon and one of the strongest in the body but it has poor blood supply, which can result in injuries that take a long time to heal.

Symptoms

Both athletes and non-athletes can develop problems with the Achilles tendon.  It usually begins with an aching or burning pain in the back of the heel, which is worse with walking and running.  Patients often complain of a burning feeling even when they just flex and point the ankle.  It is often painful to rise up onto the toes and patients often complain of pain, which is worse in the morning or after a prolonged period of rest, often referred to as start- up symptoms.

Causes

As with most tendon injuries, Achilles tendinitis is often caused by overuse or overtraining in sports, but there is often a structural component too.  Tight calf muscles and overpronation (where the ankle rolls in excessively) are common risk factors for Achilles problems because they can cause improper shear forces on the Achilles tendon. In athletes, these structural issues combined with excessive force on the tendon such as repeated pushing off and jumping can result in micro tears in the tendon. In fact, Achilles tendinitis is often a misnomer. This name meant there is inflammation in the tendon. While this is sometimes the case, more often the term tendinosis should be applied, as this refers to micro tears as the cause of pain.  Because of the poor blood supply to the Achilles tendon, inflammatory and micro tear situations can take a very long time to heal.

Treatments

  • In an acute situation, activity modification is the first course of action- repetitive stress on an inflamed and weakened Achilles tendon can result in further injury such as a tear
  • Ice and anti-inflammatories
  • A small heel lift will relieve stress on the tendon
  • In some cases the patient may need orthotics, or arch supports in their shoes to correct any structural abnormalities contributing to achilles problems
  • Calf and Achilles stretching and strengthening
  • Physical therapy may include modalities to help with pain and swelling, instruction in proper stretching and strengthening techniques, and manual therapy to help with any muscular tightness or scar tissue buildup    
 

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