Written by Dr.Jagruti Parghi

Tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. Achilles tendinitis is a common condition that occurs when the large tendon that runs down the back of your lower leg becomes irritated and inflamed.          

The Achilles tendon is the largest tendon in the body. It connects your calf muscles to your heel bone and is used when you walk, run, climb stairs, jump, and stand on your tip toes. Although the Achilles tendon can withstand great stresses from running and jumping, it is also prone to tendinitis, a condition associated with overuse and degeneration.There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed:

NON - INSERTIONAL ACHILLES TENSINITIS:-

In non-insertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.       

Tendinitis of the middle portion of the tendon more commonly affects younger, active people.

INSERTIONAL ACHILLES TENDINTIS:-

Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone. In both non-insertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify(harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.                                    

Tendinitis that affects the insertion of the tendon can occur at any time, even in patients who are not active. More often than not, however, it comes from years of overuse (long distance runners, sprinters).

CAUSES:-·       

  • Sudden increase in the amount or intensity of exercise activity—for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance·     
  • Tight calf muscles—Having tight calf muscles and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon·       
  • Bone spur—Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain.

SYMPTOMS:-·       

  • Pain and stiffness along the Achilles tendon in the morning·
  • Pain along the tendon or back of the heel that worsens with activity·       
  • Severe pain the day after exercising·       
  • Thickening of the tendon·       
  • Bone spur (insertional tendinitis)
  • Swelling that is present all the time and gets worse throughout the day with activity      

If you have experienced a sudden"pop" in the back of your calf or heel, you may have ruptured (torn)your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.

TREATMENT:-

  • Rest
  • Ice
  • Non-steroidal anti-inflammatory medications
  • Exercises:·       

- Calf stretch -Lean forward against a wall with one knee straight and the heel on the ground. Place the other leg in front, with the knee bent. To stretch the calf muscles and the heel cord, push your hips toward the wall in a controlled fashion. Hold the position for 30 seconds and relax. Repeat this exercise 5 times for each foot. A strong pull in the calf should be felt during the stretch.       

           

- Bilateral heel drop -Stand at the edge of a stair, or a raised platform that is stable, with just the front half of your foot on the stair. This position will allow your heel to move up and down without hitting the stairs.               

Lift your heels off the ground then slowly lower your heels to the lowest point possible. Repeat this step 20 times. This exercise should be done in a slow, controlled fashion. Rapid movement can create the risk of damage to the tendon. As the pain improves, you can increase the difficulty level of the exercise by holding a small weight in each hand.

- Single leg heel drop -This exercise is performed similarly to the bilateral heel drop, except that all your weight is focused on one leg. This should be done only after the bilateral heel drop has been mastered.        

  • Supportive shoes and orthotics                                
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