ACHILLES TENDONDITIS - The Facts

What is the Achilles Tendon?
The Achilles tendon is the large fibrous tissue that connects the heel to the muscles of the lower leg: the calf muscles. Leg muscles are the most powerful muscle group in the body and the Achilles tendon is the thickest and strongest tendon in the body. Contracting the calf muscles pulls the Achilles tendon, which pushes the foot downward. This contraction enables: standing on the toes, walking, running, and jumping.

What is Achilles Tendonitis?
Achilles tendonitis is a common injury that tends to occur in recreational athletes. When overused the Achilles tendon can become inflamed and this can lead to pain and swelling. Achilles tendonitis needs to be differentiated from another common with the achilles tendon, a condition called Achilles Tendinosis. Patients with Achilles tendinosis have chronic swelling of the Achilles and associated pain which are the result of degenerative, microscopic tears within the tendon.

What are the causes of Achilles Tendonitis

The common causes are:

• Lack of flexibility of the Achilles tendon
• Over pronation (too much inward rolling of the foot when the foot makes contact with the ground)
• Often occurs in sports such as running, jumping, dancing and tennis, where explosive movements to the Achilles tendon occurs, placing it under undue stress.
• Participation in a new sporting activity or increasing the intensity of participation. Changes in exercise training schedules, for example long distance runners may have symptoms of Achilles tendonitis after increasing their mileage or increasing the amount of hill training they are doing.
• Poor running technique, excessive pronation of the foot and poorly fitting footwear may contribute.
• In cyclists, the problem may be a low saddle, which causes extra dorsiflexion of the ankle when pedalling.
• Quinolone antibiotics (e.g. ciprofloxacin, ofloxacin) can cause inflammation of tendons and predispose them to rupture.
• Problems with misalignment such as unequal leg lengths, tightness or weakness in the back, hip thigh or calf muscles.
• Poor fitting or worn out training shoes or shoes.
• Sports shoes with too much or too little arch support, cushioning, heel support or control when the foot is pronating,
• Always wearing high heels causing the Achilles tendon to shorten

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Tendons age just like their owners, and like other tissues in the body, become less flexible, more rigid, and more susceptible to injury. Therefore, middle-age recreational athletes are most susceptible to Achilles tendonitis.
 
Symptoms of Achilles Tendonitis
The main complaint associated with Achilles tendonitis is pain behind the heel most commonly in an area about 2-4 centimeters above where the tendon attaches to the heel. It is here where the tendon makes this area particularly susceptible due to the blood supply of the tendon. People usually experience the most significant pain after periods of inactivity, particularly when first getting up in a morning and when getting up after sitting for long periods of time. They may also experience pain while participating in activities, such as when running or jumping.

Also see Treatment for Achilles Tendonitis and Achilles Tendinosis

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