Achilles tendonosis is a condition that affects the Achilles tendon. The calf muscle runs down the lower leg and attaches to the heel, or calcaneus bone. The tendon can absorb an incredible amount of force when we walk, run, or jump. Certain activities may cause the Achilles to absorb more than 10 times your body weight.
Explosive activities Obviously increase the stress such as running, jumping, basketball, baseball, softball, or sprinting. However, walking long distances also can damage the achilles. Injuries can range from mild tenderness and soreness to a large painful nodule. The tendon can even completely rupture.
Many people think they need to be involved in an active or explosive sport to cause Achilles pain. However, people have ruptured their Achilles by stepping out curbs or playing laser tag with their kids.
Mild sprains can be treated with rest, ice, and over the counter NSAIDs. A little rest and a lot of ice goes a long way in recovery. Trying to push through the pain often increases the severity of the injury. The Achilles tendon is under constant stress when standing or walking, which limits the amount of healing that occurs.
Delaying treatment can often be harmful to recovery. People wait too long and mild sprains become several injuries that take week to months to heal.
Signs and Symptoms
Symptoms of Achilles tendonitis usually start out as mild tenderness when rubbing your achilles. The tendon then becomes stiff after activity. Sometimes people notice the leg being stiff multiple times a day. They may notice tightness in their calf muscles or a dull ache in their leg. It ever becomes more tender to the touch or when wearing certain shoes cause a painful rub.
The Achilles ever developed a bump or swollen area. This small swollen “bump” is the area of injured fibers. This bump will continue to increase in size and tenderness as the condition worsens. People often experience less pain after walking for several minutes, but the pain returns after sitting. As the injury progresses the pain will feel more intense and occur more frequently, and swelling and soreness may increase.
Causes of Achilles Tendonitis
Any activity that causes force on the foot and ankle can cause tendinosis. It is not just basketball, plyometrics, jumping, tennis or running.
Running does put stress on the tendon, and enough stress can lead to injuries. This is common with runners who either increase their weekly miles, begin sprinting, or run more hills.
Imagine the Achilles tendon as a rope connecting the calf muscles to the heel bone. The rope is absorbing stress and straing with each step. Too much stress will eventually cause the rope to “fray.” Every step afterward pulls on the “fray” and results it from healing.
Treatment for Achilles Tendonosis
Stretching is very important. Treatment should invovle decreasing spasms in the lower legs, calves, and hamstrings. When these muscles are tight they increase the stress across the Achilles tendon.
Runners and athletes will need to change their training schedule and work out routines. People often need to change their shoes. Old and worn out shoes increase the pounding forces into the foot. When excess foot pronation is also a contributing factor to Achilles pain. Some people do better with orthotics.
Initial treatment of Achilles tendonosis is ice and rest. Immediate goals are to decrease swelling and encouraging healing of the “frayed rope.” Other treatments to decrease pain and inflammation include electric therapy, ultrasound, stretching, cold laser, KT taping, and proprioceptive therapy. Foot strengthening exercises are needed in people who over pronate.
Many times chronic Achilles Tendinosis requires treatment to stimulate fibroblast and decrease scar tissue formation. Graston Technique is a therapy used to accomplish these goals.
Prevention of Achilles Injuries
Prevention of Achilles tedinosis involves slowly increasing training volume. Individuals who increase their training volume by more than 10% are more likely to experience injuries. Runners who suddenly increase training volume or add explosive plyometric training are likely to develop achilles pain. Once again, be smart with your training. Cross training can be helpful with people who have a history of Achilles injuries.
Remember that any pain is a warning sign that something is wrong. Ignoring the problem when it is small often leads to a more extensive injury. Prevent small Achilles injuries from becoming large injuries that require more time and treatment to correct by acting early.
Achilles tendonitis can be successfully treated by providers who are experienced with Achilles injuries and who utilize therapies such as the Graston Technique for faster results. Ice is your best friend in Achilles tendinosis. People are often resistant to icing. They ever become frustrated enough to ice 5-10 times a day and quickly notice a difference in pain levels. Ice early and often. Some is good and more is better with Achilles sprains.