Achilles Tendonitis

The Achilles tendon is the largest tendon in the body connecting the calf muscles to the heel bone and is in use when walking, running, and jumping. Athletes and runners in particular tend to be those who suffer the most with Achilles tendonitis and it is the bane of many runners. Although this tendon can withstand great stresses it is also prone to tendinitis, a condition associated with degeneration and overuse.

Historically, the Achilles tendon is known as an area prone to disabling injury. Named after Achilles, who according to myth, was protected from wounds. As a baby, his mother dipped him in a special pond by holding onto his heel, which was not immersed; and later in life Achilles died by an arrow wound in his heel. Interestingly, injuries to this part of the body have obviously been around for thousands of years; however, it was only first reported in medical literature 400 years ago.

What Is Achilles Tendonitis?

The Achilles tendon is the largest tendon in the body stretching from the heel to the calf muscles. From the exterior it feels like a springy band of tissue at the back of the ankle, above the heel. This tendon joins three muscles: the soleus and the two heads of the gastrocnemius. The gastrocnemius muscle crosses over three joints: the knee, the ankle, and the subtalar joint. The soleus is the powerful muscle in the back part of the lower leg; it reaches from just below the knee to the Achilles tendon.

There is not a rich blood supply to this tendon; there are a small number of blood vessels throughout its length which suggests the poor vascularity can be an issue when trying to repair the tissue following trauma.

Achilles Tendonitis

There are two types of Achilles tendonitis: insertional and noninsertional. Insertional Achilles tendonitis affects the lower portion of your tendon where it attaches to the heel bone. Noninsertional Achilles tendonitis involves fibers in the mid-portion of the tendon and usually affects active, younger people.

There are several factors that can contribute to Achilles tendonitis. Here are a few factors:

• Excessive hill running,
• Improper placement of the foot while exercising or while engaged in a sports activity,
• Sudden increases in training, or exertion in activity involving the tendon,
• Not properly stretching the tendon before, during and after physical activity, and
• Tightness of the posterior muscles in the calf that was not stretched out prior to physical activity.

Shoe design may prolong Achilles tendonitis because of excessive heel cushioning. Some people self-treat and purchase gel or air-filled heels and these are not good for a sore Achilles tendon. If you are wearing a shoe designed to provide heel shock absorption what frequently happens is that after heel contact, the heel continues to sink lower while the shoe is absorbing the shock. This further stretches the Achilles tendon.

Achilles Tendonitis Symptoms

Common symptoms include:

• Pain and stiffness along the tendon in the morning,
• Pain along the tendon or back of the heel that worsens with activity,
• Severe pain the day after exercising, and
• Swelling.

If you have experienced a sudden "pop" in the back of your calf or heel, you may have torn your Achilles tendon. If this has occurred it is important to help right away.

Treatment

The good news is that there are many nonsurgical treatment options that will work for most patients. Depending on the severity of the injury it may take a few months for symptoms to completely subside. Also, depending on how soon you seek help after getting Achilles tendonitis will determine the length of treatment required.

Some basic tips to follow for alleviating pain at home include:

Rest. Greatly decreasing or even stopping the activities that make the pain worse is a must. If you regularly partake in high-impact exercises then switch over to low-impact activities, this will put less stress on the Achilles tendon. Biking and swimming are low-impact options to help you stay active.

Ice. Placing ice on the most painful area of the tendon is helpful and can be repeated as needed throughout the day. This can be done up to 20 minutes each session so long as the skin does not get numb.

Exercise. There are some incredible exercises that can help to strengthen the calf muscles and reduce stress on the Achilles tendon. A qualified health professional can show you what specific exercises are best for your particular situation.

At home methods may provide some relief but there is not a doubt that seeking qualified professional help is best in order to heal properly.

For more information about Achilles tendonitis and how chiropractic and physiotherapy can help you, please give Chiro-Med a call. Established in 2007 by Dr. Behfar Sanjari, Chiro-Med Rehab Centre has been committed to providing quality health care services to the Greater Toronto Area for a decade. We have clinics located in Richmond Hill and Newmarket; call 905-918-0419 or 905-235-2620 for more information.