ACHILLES TENDONITIS – Symptoms, Treatment And Prevention

 

 

We all start off our new fitness regime with the best intentions, full of gusto with the youthful exuberance of a toddler that’s just learnt to walk.

The problem is that we often try to run before we can walk, which tends to lead to injury and ultimately puts a halt to our fitness plan and sets us back even further.

As a massage therapist, one of the most common injuries I encountered was Achilles Tendonitis from people pushing too hard in a new activity.

It’s also an injury I painfully had to endure when I first got into boxing and started to skip a lot without allowing my body to adapt to the new movement.

In this article we will look at the anatomy of the Achilles Tendon, what causes Achilles Tendonitis, how it can be treated and how it can be prevented.  

 

What Is The Achilles Tendon?

 

The Achilles tendon is the co-joined tendon at the back of the ankle which connects from the bottom of the two large calf muscles known as the Gastrocnemius and Soleus, and runs down the back of the lower leg to join onto the heel bone, which is called the Calcaneus.

The Achilles tendon is what enables us to plantaflex our foot (raising us up onto our toes), facilitating the act of walking.

The Achilles tendon derives its name from Achilles who was a mighty warrior in Ancient Greek mythology. Legend has it that his mother dipped him into the magical waters of the river Styx at birth.

She did this in order to make him physically invulnerable. Many years later, Achilles was killed when an arrow struck him in the heel. The myth states that this was his only vulnerable spot as it was the only part of him that was not touched by the magical waters, since his mother was holding him by his heels whilst dipping him.

 

What Causes Achilles Tendonitis?

 

‘It is estimated that nearly 70% of those who jog or run will sustain some sort of running injury and 11% of all them running injuries can be due to Achilles tendonitis.

Achilles tendonitis is an injury to the Achilles tendon causing it to inflame and degenerate. It can be caused by a number of factors, which all consist of continuous aggravation to the tendon via activities that repetitively stress the tendon which causes the tissues to tear. Achilles tendonitis can be caused by either a single incident of overstretching the Achilles tendon or it may result from a number of smaller stresses on the tendon that produces numerous small tears over time.

These tears can occur where the tendon attaches to the heel or along any part of the tendon itself. This tends to cause either a shooting pain, burning sensation or even an extremely piercing pain.

People suffering from Achilles tendonitis often complain about how extremely painful their first steps out of bed are. This pain often lessens slightly with activity.

This injury is common among athletes who take part in sports that require a lot of stop start movements such as basketball, football, tennis and running.

The injury is not only exclusive to athletes, however it is always more difficult to treat an athlete due to their high level of activity and unwillingness to corporate as they are reluctant to stop or slow down their training.

Women who tend to wear high-heeled shoes throughout the day and change into trainers when they exercise are also vulnerable to developing Achilles tendonitis. The most common cause is over-pronation, where the arch of the foot collapses bearing excess weight stressing the Achilles tendon.

 

How To Treat Achilles Tendonitis?

 

The type of treatment for Achilles tendonitis depends on how severe the injury is. However, ignoring the problem and pushing through the pain will not treat Achilles tendonitis, as this may cause the tendon to become weak and rupture.

The Achilles tendon has a very slow healing cycle due its poor blood supply.

This injury can be either acute or chronic.

Acute tendonitis tends to happen as a result of overuse or training too much too soon ,particularly on hard surfaces or up hills.

If an individual ignores the warning signs of Achilles tendonitis or it is not allowed to heal properly then the injury can become chronic.

Chronic Achilles tendonitis is a difficult condition to treat. If the damage to the tendon is only minor, physicians will usually advise a simple course of treatment of RICE (rest, ice, compression, and elevation).

• The patient must rest the tendon by staying off their feet as much as possible.
• Ice packs must be applied for 20 minute intervals every hour for a day or two so as to reduce swelling.
• The foot and ankle must be compressed firmly but not tightly by being wrapped in elastic bandage.
• And lastly, the foot must be elevated whenever possible in order to minimize blood accumulation and swelling.

Once the initial swelling has reduce you can slowly start working on the area with cross fiber friction massage and some light stretches to aid and speed up recovery.

Check out the video below for a full breakdown of the massage technique and stretches you can do on your own if it is something that you are currently suffering with.

 

 

If injury to the tendon is severe then it will take longer to heal and a different treatment would need to be used if the basic treatment did not work. In severe cases a flexible cast on the foot can be used to immobilize the injury and reduce swelling.

Crutches can also be used to keep weight off the injury for up to 8 weeks allowing the achilles enough time to heal.

If all is successful with the treatment, it is recommended that the patient wears low-heeled shoes and is given a program of rehabilitation exercises to gradually stretch the tendon before resuming full activity.

In rare cases, severe Achilles tendonitis may require surgery and lengthy rehabilitation.

Surgery involves removing the tendon’s inflamed outer covering and re-attach the torn tissues. Fortunately, most cases of tendonitis respond to less persistent treatments and surgery is required only to repair the most traumatic injuries, such as a rupture of the tendon or tearing away from the heel.

At the beginning of any functional progression is the SAID principle. SAID is an acronym for Specific Adaptations to Imposed Demands. This principle basically means that all rehabilitation should be geared towards the demands that will be placed on the individual upon returning to their previous function.

Although not something I like to recommend, in the initial stages though, a nonsteroidal anti-inflammatory drug (NSAID), to reduce pain, swelling, and inflammation can help with dealing with the pain and reducing inflammation in the short-term. The drug itself inhibits inflammatory reactions and pain. It more than likely does this by decreasing the activity of the enzyme cyclooxygenase, which results in inhibition of prostaglandin synthesis.

Achilles tendonitis can also be treated naturally via anti-inflammatory agents such as Turmeric which I discuss in the article, Turmeric And Black Pepper – A Powerful Anti – Inflammatory.

Another natural form of dealing with the inflammation of Achilles tendonitis is by eating an anti-inflammatory diet which can decrease the discomfort associated with the inflammation and also reduce systemic inflammation and the risk of associated diseases.

Such a diet will consist of fresh vegetables and fruits, flax-seed oil, fish and organically raised foods.

It’s advisable to avoid sugar and any refined white flower products such as pasta and bread and saturated fats, processed and fast foods should also be avoided.

 

How Can Achilles Tendonitis Be Avoided?

 

Wearing good conditioned and proper fitting, low-heeled shoes may prevent Achilles tendonitis.

In addition, before beginning an activity, runners and others who engage in sports or physical exercise should always warm up and stretch properly. Cold muscles are inflexible and working them hard without stretching creates excessive stress, not only to the muscles, but also to the tendons.

For example, jumping jacks, light jogging, gentle stretching, or massage should always precede intense exercise. If discomfort occurs, the activity should be stopped immediately and ice must be placed on the affected area to relieve inflammation.

It may be advisable to consult a physical trainer to determine whether a flaw in the person’s warm up routine or exercising method is contributing to the problem.

Ice packs could be applied after every training session if the achilles area feels tender and a lightweight orthotic device, heel cup or heel cradle is advisable to give extra support. These devices help by elevating the heel to reduce stress and pressure on the Achilles tendon.

The best advise would be to slowly ease into a new fitness regime or activity.

I know its hard as we tend to get excited and want to get stuck in, but you need to allow your body to gradually adapt to the new stresses you’re putting onto it.

This article was on the symptoms and treatment of Achilles Tendonitis but the best treatment for such an injury is prevention.

Like anything diet or fitness related – slow and steady will always win the race.