What is Achilles Tendonitis?
Achilles tendonitis is inflammation along the Achilles tendon found on the back of the lower leg attaching the calf muscles to the heel bone. The Achilles tendon is the largest tendon in the body and is responsible plantarflexion of the ankle (causing the front of the foot to lower and lift the heel off the ground). Achilles tendonitis is typically caused by overuse (running and jumping type exercises).
What are causes of Achilles Tendonitis?
Achilles Tendonitis is usually due to overuse, but this tends to happen in specific situations:
• Sudden increase in the amount or intensity of activity
• Tight calf muscles
• Running on hard surfaces such as concrete
• Running too often
• Frequent jumping activities (such in volleyball or basketball)
• Using shoes with improper support
How is Achilles Tendonitis Diagnosed?
Typically only a physical exam is needed to diagnose Achilles Tendonitis. In some more involved cases Diagnostic Ultrasound and even an MRI may be warranted.
What is the treatment for Achilles Tendonitis?
Most cases of Achilles Tendonitis can be treated conservatively. This involves a number of modalities including:
• Decreasing or stopping all high impact activity until the acute inflammatory phase has passed.
• Running or walking on softer or smoother surfaces.
• Switching to swimming or biking for aerobic activity
• Stretching exercises
• Strengthening exercises with eccentric contractions of the Achilles.
• Heel lifts in the shoes
• Foot Orthoses
If you are suffering from any foot pain, see The Podiatrist.
Stay stable on your feet- The ankle is built to support your body’s load but uneven distribution of weight can leave it vulnerable
I wish I had a dollar for every time I hear my clients say “weak ankles”. The ankles are built to support nearly 100% of the body’s load, and if you look at the role of the joint in any sport which involves being on your feet, you will see that it can take very high impacts. It is flexible, resilient and capable of generating some serious explosive movements. So why do I see so many ankle injuries?
Understanding how such a brilliantly designed joint can turn weak lies in studying its functional relationship and interaction with the body’s other weight–bearing joints—the hips, knees and shoulders. The human body is a structure with several load-bearing joints, all of which will function at their optimum only if they are engaged together as a single unit—much like a well-made chair. The sturdy chair will bear the weight of the guest sitting on it pretty efficiently for years, but if people keep tipping the chair back and forth on its rear and front legs alternately, the chair will start wobbling and may ultimately collapse altogether. In the same manner, the body’s load-bearing joints will lose the benefit of its combined strength if the load is not distributed evenly along the shoulders, hips, knees and ankles. If anyone has to compensate regularly for the other, then that joint will deteriorate.
The ankle is particularly vulnerable as it bears the maximum load of the human body. This explains the high number of ankle-pain sufferers. The solution, however, does not lie in artificial support systems like taping, or special high-top shoes, or even surgery—it lies in spotting the deviant joint, understanding its relationship with the muscles around it, and aligning it with the rest of the load-bearing joints.
Calf muscles and ankles
The most common cause of ankle pain is dysfunctional and unusually shortened or tight calf muscles. For a human body to achieve proper locomotion, it is extremely important that the feet are able to dorsiflex. Dorsiflexion is the technical term used to describe the motion when the toes and feet move inwards towards the shin bone. While walking or running, when the foot hits the ground on impact, the shin has to move towards the feet in order to create the proper “give” or soft cushioning. This is only possible if the calf muscle is flexible and functional. If the calf muscle is tight, then the ankle abducts (moves outwards from the shin), unusually increasing its workload at impact. Moving away at impact takes it out of line to bear the body’s weight evenly, so there is too much load now acting on the inside of the ankle. Simple stretches to restore length back to the calf muscles, like the ones we will outline, sometimes take away chronic pain in the ankles, and make the joint more stable.
The Achilles tendon
The Achilles tendon attaches the muscles of the calf to the heel of the foot, and is hurt more often than any other tendon. The Achilles tendon’s opposing tendons attach the two heads of the gastrocnemius muscle (part of the calf muscle) to the two sides of the femur bone which significantly also form a part of the knee joint. Any misalignment of the knee joint, then, disrupts the tension and interaction of the tendons. The Achilles tendon, instead of delivering a fluid, smooth contraction, starts “twanging” and crimping. The Achilles tendon is not built to snag or to move such loads without help from the lower leg, hip or knee.
See The Podiatrist if you are experiencing any problems.