Achillies Tendonitis is an inflammation of the Achilles tendon. The Achilles is the large tendon connecting the two major calf muscles, the gastrocnemius and the soleus, to the back of the heel bone. Under too much stress, the tendon tightens and is forced to work too hard. This causes it to become inflamed (that is tendinitis) or degenerative (tendonopathy), and, over time, can produce a covering of scar tissue, which is less flexible than the tendon. If the inflamed Achilles continues to be stressed, it can tear or rupture.

Symptoms
Symptoms can include a dull or sharp pain anywhere along the back of the tendon, but usually 5cm above the heel. Limited ankle flexibility, redness or heat over the painful area are also common as well as a nodule (a lumpy build-up of scar tissue) that can be felt on the tendon or a cracking sound (scar tissue rubbing against tendon) with ankle movement.

Causes
• Runners who over pronate (feet that rotate too far inward on impact) are susceptible to Achilles tendinitis. Over pronation places an increased amount of stress on the tendon.
• Tight or fatigued calf muscles, which transfer the burden of running to the Achilles can also contribute to Achilles tendonitis. This can be due to poor stretching, rapidly increasing distance, or over-training with excessive hill running or speed work.
• Inflexible running shoes, which, in some cases, may force the Achilles to twist, can also contribute.

Treatment
• Rest – One way to reduce the symptoms of Achilles tendonitis is to avoid or modify those activities which aggravate the condition.
• Ice – Ice will help reduce inflammation in to the area and will also help to reduce pain involved with the injury. Ice should be applied for 10 minutes 3 times per day, or following activity.
• Foot Strapping – helps correct any mechanical abnormalities in your feet that will affect your lower limb function. If strapping has reduced the amount of pain then an orthotic may be used as permanent measure.
• Orthotics – used when there is a mechanical deformity in the bony structure of the foot (usually causes rolling in). Orthotics balance the foot which allows the foot to function more efficiently. Misalignment of the foot will also cause the leg to be misaligned. This will cause the muscles that help to slow pronation (the calf group) to be overworked.
• Physiotherapy- due to the chronic nature of Achilles tendonitis and the relative lack of blood supply to the region, Physiotherapy treatment is usually necessary to help regain flexibility to the calf group and to help to reduce pain and swelling.
• Stretching Strengthening – A specific exercise program stressing calf muscle stretching and strengthening may be necessary to speed recovery.
• Night Splints – used to stretch the calf muscle groups while you sleep. These are used if conventional stretching is ineffective.
• Modify Activity – Swimming is generally the most well tolerated fitness activity. In choosing a fitness program, one should use pain and swelling as a guide.
• Surgery – Used when all of the above treatments have failed. This usually involves scraping scar tissue off the tendon and is a last resort.

Recovery
Your recovery will depend on your individual health. Achilies tendonitis normally takes about 6 to 8 weeks for a healthy individual to recover. This of course depends on the duration the condition has been untreated for.

For any more information please contact Wade, our friendly podiatrist at Chevron Island Physio. 5504 7000.