What is it?

Achilles tendonitis is simply inflammation of the Achilles tendon at the back of the ankle. It is one of the most common tendon injuries and should always be treated as early as possible. It is a condition that can be quite debilitating and is usually associated with swelling and pain. Sometimes the tendon may thicken, and a nodule (a lumpy build-up of scar tissue) may be felt in it.

What causes it?

There are several factors that can contribute to Achilles tendonitis-

The most common is overuse of the muscle/tendon following initial injury to the tendon.

A poorly functioning foot can cause the heel to shift outwards and “bow” the Achilles tendon. This damages the tendon sheath, resulting in painful inflammation of the area. This abnormality must be neutralised to stop recurrence of injury.

A sudden increase in training – duration/intensity, excessive hill running, speed work, or training on uneven surfaces can cause tearing of the Achilles tendon. Excessive heel cushioning and air-filled shoes can, over a period of time, lose their stability. Continued use of this footwear can cause the heel to sink into the shoe. This further stretches the Achilles tendon during times when the leg and body are moving forward over the foot.

Tight calf and hamstring muscles may contribute to prolonged Achilles tendonitis, due to the continual “pulling” strain they exert on the tendon.

How is it treated?

Achilles tendonitis is a condition that responds well to conservative treatment, if treated early. Conservative treatment involves:

R.I.C.E. (Rest, Ice, Compression, Elevation).

Specific Exercises – prescribed by your Podiatrist (i.e. Heel Drop Therapy)

Heel raises – To decrease the strain and load on the Achilles tendon, heel raises may be used for a short time.

Correction of abnormal mechanics – Orthotic Appliances are designed to allow the foot to function around position which reduces abnormal forces being applied to the achilles tendon. This allows the Achilles tendon to recover and prevent recurrence of the injury.

Stretching and physical therapy – specific stretching and strengthening exercises may be needed.

Extracorporeal Shock Wave Therapy

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