Tendons are thick cords of tissue that connect muscles to bone. The Achilles Tendon, located at the back of the ankle joint, connects the calf muscles to the heel bone. The Achilles is the most powerful tendon in the body. It can lift eight to 10 times a patient’s body weight under distress. This tendon helps in balancing the body, pushing the legs forward while walking, and bouncing the legs while running or jumping.
Achilles Tendonitis is a term that commonly refers to an inflammation of the Achilles tendon or its covering. It is an overuse injury that is common, especially among people who are active in sports, due to the repetitive action.
Common Causes of Achilles Tendonitis are:
· Over-training or unaccustomed use – “too much too soon”
· Sudden change in training surface – e.g. grass to bitumen
· Flat (over-pronated) feet
· High foot arch with tight Achilles tendon
· Tight hamstring (back of thigh) and calf muscles
· Toe walking (or constantly wearing high heels)
· Poorly supportive footwear
· Hill running
· Poor eccentric strength
Older athletes are more prone to Tendonitis than younger athletes.
Swelling and Pain are the most prominent symptoms, associated symptoms are stiffness, and loss of strength.
Management of Achilles Tendonitis
Rest and ice can ease the pain of tendinitis. Stay off your foot or ankle as much as possible and apply ice for up to 15 minutes at a time, three to four times a day. Stretching and activity modification is advised. Treating tendinitis would be to achieve the following
· Pain Reduction
· Improve the range of pain-free motions of the tendon
· Restore eccentric muscle strength
· Normalize foot biomechanics
· Restore Power, Proprioception, and Agility
· Return to sport
Functional foot orthosis would help in achieving all the above goals in the management of tendinitis. In the worst-case scenario where the tendon is ruptured or torn, surgery needs to be considered immediately. Most of these injuries take six months or more to adequately rehabilitate. It is not uncommon for a patient to return to activities too quickly and re-injure the tendon. Careful monitoring of a return to full activity is important and the patient must have patience during this period.