Achilles tendon injuries are one of the most common overuse injuries in recreational sports. A very small percentage of these injuries are diagnosed and treated by doctors of chiropractic. What is especially interesting is that a high percentage of these injuries are caused by a posterior calcaneus subluxation.
Achilles tendinitis can be caused by overly tight calf muscles, excessive running up hill or down hill, a sudden increase in the amount of exercise, e.g. running for a longer distance, wearing ill-fitting running shoes, such as those with soles that are too stiff, or wearing high heels regularly, or changing between high heels all day and flat shoes or low running shoes in the evening. Overuse is common in walkers, runners, dancers and other athletes who do a lot of jumping and sudden starts/stops, which exert a lot of stress on the Achilles tendon. Continuing to stress an inflamed Achilles tendon can cause rupture of the tendon – it snaps, often with a distinctive popping sound. A ruptured Achilles tendon makes it virtually impossible to walk. An Achilles tendon rupture is usually treated by surgical repair or wearing a cast.
There are several types of Achilles tendinitis symptoms, but all of them are closely related. People who suffer from Achilles tendon pain typically have swelling in the Achilles tendon, and that pain can be chronic as the microscopic tears in the area become more prevalent over time. The most intense pain is typically located just a few centimeters above the area where the tendon meets the heel. This area is called the watershed zone, and the amount of blood moving through it is what gives it the highest potential for injury, especially for athletes. Most of the Achilles tendinitis symptoms in people with the condition will happen immediately after they have been inactive for a fairly significant amount of time. That means that the most pain will generally be felt after sitting or lying down for an extended period, or right after waking up in the morning and getting moving. If you aren?t positive that you are suffering specifically from Achilles tendinitis symptoms, consult a doctor to make sure.
There is enlargement and warmth of the tendon 1 to 4 inches above its heel insertion. Pain and sometimes a scratching feeling may be created by gently squeezing the tendon between the thumb and forefinger during ankle motion. There may be weakness in push-off strength with walking. Magnetic resonance imaging (MRI) can define the extent of degeneration, the degree to which the tendon sheath is involved and the presence of other problems in this area, but the diagnosis is mostly clinical.
The aim of the treatment is to reduce strain on the tendon and reduce inflammation. Strain may be reduced by, avoiding or severely limiting activities that may aggravate the condition, such as running, using shoe inserts (orthoses) to take pressure off the tendon as it heals. In cases of flat or hyperpronated feet, your doctor or podiatrist may recommend long-term use of orthoses. I8nflammation may be reduced by, applying icepacks for 20 minutes per hour during the acute stage, taking non-steroidal anti-inflammatory drugs, placing the foot in a cast or restrictive ankle-boot to minimise movement and give the tendon time to heal. This may be recommended in severe cases and used for about eight weeks. Occasionally depot (slowly absorbed) steroid injections may be tried, particularly for peri-tendinitis, but great care needs to be taken to avoid injecting into the tendon. This should only be done by a specialist doctor. You may also be given specific exercises to gently stretch the calf muscles once the acute stage of inflammation has settled down. Your doctor or physiotherapist will recommend these exercises when you are on the road to recovery. Recovery is often slow and will depend on the severity of the condition and how carefully you follow the treatment and care instructions you are given.
Surgery can be done to remove hardened fibrous tissue and repair any small tendon tears as a result of repetitive use injuries. This approach can also be used to help prevent an Achilles tendon rupture. If your Achilles tendon has already ruptured or torn, Achilles tendon surgery can be used to reattach the ends of the torn tendon. This approach is more thorough and definitive compared to non surgical treatment options discussed above. Surgical reattachment of the tendon also minimizes the change of re-rupturing the Achilles tendon.
While it may not be possible to prevent Achilles tendinitis, you can take measures to reduce your risk. Increase your activity level gradually. If you’re just beginning an exercise regimen, start slowly and gradually increase the duration and intensity of the training. Take it easy. Avoid activities that place excessive stress on your tendons, such as hill running. If you participate in a strenuous activity, warm up first by exercising at a slower pace. If you notice pain during a particular exercise, stop and rest. Choose your shoes carefully. The shoes you wear while exercising should provide adequate cushioning for your heel and should have a firm arch support to help reduce the tension in the Achilles tendon. Replace your worn-out shoes. If your shoes are in good condition but don’t support your feet, try arch supports in both shoes. Stretch daily. Take the time to stretch your calf muscles and Achilles tendon in the morning, before exercise and after exercise to maintain flexibility. This is especially important to avoid a recurrence of Achilles tendinitis. Strengthen your calf muscles. Strong calf muscles enable the calf and Achilles tendon to better handle the stresses they encounter with activity and exercise. Cross-train. Alternate high-impact activities, such as running and jumping, with low-impact activities, such as cycling and swimming.