Achilles Tendinitis Treatments
Achilles tendinitis is a painful and often debilitating inflammation of the Achilles
tendon, also called the heel cord. This large tendon is an extension of the two calf
muscles; it runs down the back of the lower leg and attaches to the heel bone (calcaneus).
The Achilles tendon connects the strong leg muscles to the foot and gives us the ability
to rise up on our toes, facilitating the act of walking. The Achilles tendon is vital to
our ability to walk upright and Achilles tendonitis can make walking almost impossible.
The Achilles tendon derives its name from Achilles, the mighty warrior of Greek
mythology, whose mother dipped him into the magical waters of the river Styx at birth to
give him physical invulnerability. According to legend, she held him by the heel, which
was not touched by the mystic waters and therefore remained his only vulnerable spot. Many
years later, he was killed when an arrow struck him in the heel.
Causes of Achilles tendinitis
Achilles tendinitis is often an ailment of athletes. Baseball, football, and tennis
players, runners, and dancers are particularly susceptible to it because their activities
involve sudden stops and starts, as well as jumping and other actions that stress the
tendon. Women who wear high-heeled shoes often and switch to sneakers for exercise also
can develop Achilles tendinitis.
The inflammation that characterizes tendinitis reflects tearing of the tendon tissues
caused by excessive stress. The problem may be caused by a single incident of
over-stressing the Achilles (such as failing to stretch or "warm up"
sufficiently before exercising) or it may result from an accumulation of smaller stresses
that produce numerous small tears over time. The injury may occur at the point where the
tendon attaches to the heel or at any point along the length of the tendon.
Sometimes an inborn trait causes Achilles tendinitis. Typically, this is due to
abnormal pronation that causes the arch of the foot to flatten too much and the leg to
twist more than normal. This, in turn, causes the lower leg muscles (the gastrocnemius and
the soleus) to stretch more than normal. Like a rubber band, the further the muscles
stretch, the tighter they become. The force on the Achilles tendon and the calcaneus
increases, resulting in inflammation and pain.
Because the arch of the foot flattens over time, especially in athletes, someone may be
problem-free for years and develop Achilles tendinitis later in life. The condition also
is common in the "weekend warrior" who exercises infrequently, and those who are
just starting to exercise. In these people, the muscles and tendon have little flexibility
because of inactivity. Overdoing exercise in the beginning can cause tendinitis because
the muscles are not flexible enough to withstand the new forces being placed upon them. It
is especially important for people who are just starting to exercise to stretch properly,
start slowly, and increase gradually.
If pain develops even with proper stretching and training techniques, the patient
should consult a podiatrist to check for hyperpronation and adequate arch
support. The addition of an orthotic may be enough to maintain good arch and
foot alignment and eliminate pain.
In women who wear high-heeled shoes often, the Achilles tendon and muscles gradually
adapt to a shortened position because the heel does not stretch all the way to the ground.
When this occurs, switching to sneakers or flat shoes forces the Achilles tendon to
stretch further than it is accustomed to and it becomes inflamed. For this reason, high
heels should not be worn everyday. If they are deemed necessary, stretching should be done
every morning and night to keep the Achilles tendon lengthened.
Symptoms of Achilles tendinitis
In most cases, symptoms develop gradually. Discomfort may be relatively minor at first
and worsen if the patient tries to "work through" the pain. The initial
discomfort is often attributed to the aches and pains that accompany age or fatigue.
Repeated or continued overstress increases the inflammation and, in severe cases, a
rupture of the tendon can occur. This results in traumatic damage and severe pain, making
walking virtually impossible, taking a long time to heal, and sometimes requiring