Help for Achilles Tendonitis
Achilles tendonitis is one of the most common reasons people experience pain in their lower limbs. The Achilles tendon, which connects the calf muscle to the foot, is extremely strong, but it is also constantly under a great deal of stress. Much of what podiatrists do revolves around helping patients to recover from Achilles tendonitis in a sustainable way, so we thought it would be a good idea to describe in more detail what it is, how it is treated, and how it can be prevented.
Understanding Achilles Tendonitis
The Achilles tendon is the cord that lifts up the foot when we move. It is at particular risk of suffering from wear-and-tear injuries in runners and in middle-aged people. In younger, more active people, it tends to take the form of noninsertional Achilles tendonitis, which means that the middle part traveling along the ankle is inflamed. In people who are older but still active, it more often is insertional tendonitis, which means the part adhering directly to the heel bone is inflamed.
The development of Achilles tendonitis is often related to the condition of the calf muscle. When the muscle is tight, the tendon has to stretch further. If the arch of the foot is flat or there is a bony bump on the back of the heel, the tendon might also be overextended. Although inflammation is part of the body’s natural immune response to an injury, if the tendon is being repeatedly re-injured, the fibers that comprise it may wear away. This is called tendinosis. The phrase tendinopathy is used to refer to any kind of problem in or around the tendon. One sign of tendinopathy is soreness, especially after vigorous exercise, but also after a person has been at rest for hours. An inflamed Achilles tendon will often feel far more painful when it is squeezed from the sides then when it is pushed on the back.
Treatments for Achilles Tendonitis
Achilles tendonitis varies widely in severity, and there are a wide range of treatments for it. After an ankle injury, patients are advised to keep their ankle immobile and to prevent inflammation by applying ice. (It shouldn’t be placed directly on the skin, and not for longer than fifteen minutes at a time, with fifteen minute breaks in between.) However, keeping still for too long may cause the calf muscle to continue to tighten. A podiatrist may recommend physical therapy in the form of stretches as a patient gradually returns to activity, and they may also provide customized shoe inserts to either lift the heel or provide better support to the arch.
In chronic cases, a podiatrist might use ultrasounds to take an image of the soft tissue inside the foot, as well as an x-ray to determine if there is a problem with the bones. Treatment options include orally administered non-steroidal anti-inflammatory drugs and a splint to be worn at night that will help stretch the calf muscle. If inflammation persists, a podiatrist may say it is time to consider surgical options, such as removing a bony heel bump or removing the damaged portion of the tendon. The removed portion would then be replaced with a bit of tendon from elsewhere in the foot where it is less necessary. Although these surgeries are not a first resort, they do have high rates of success.
Prevention
People who have suffered Achilles tendonitis are at heightened risk for suffering it again, so podiatrists recommend ways of avoiding it. These include regularly replacing running shoes to ensure the feet are being properly supported, focusing more during work-outs on ensuring the strength and flexibility of the calf muscles, and on choosing activities that won’t subject the body to as many impacts.