tendon is the largest and strongest tendon in the human body. It is the ?cord? in the back of the leg that inserts into the back of the heel. The Achilles tendon got its name, according to Greek
legend, when the Greek warrior, Achilles, was dipped into the River Styx by Thetis, his mother. This rendered him invincible with the exception of his unsubmerged heel. Unfortunately, he went on to
get mortally wounded during the siege of Troy when he was struck in that heel by an arrow. Achilles tendinitis is inflammation and partial tearing of the Achilles tendon. It can occur with overuse of
the tendon such as when starting or increasing the intensity of an exercise program or performing impact loading activities that include a lot of running and/or jumping.
Tight or tired calf muscles, which transfer too much of the force associated with running onto the Achilles tendon. Not stretching the calves properly or a rapid increase in intensity and frequency
of sport training can make calf muscles fatigued. Activities which place a lot of stress on the achilles tendon, such as hill running and sprint training, can also cause Achilles Tendinitis. Runners
who overpronate (roll too far inward on their feet during impact) are most susceptible to Achilles Tendinitis. Runners with flat feet are susceptible to Achilles Tendinitis because flat feet cause a
'wringing out' effect on the achilles tendon during running. High arched feet usually absorb less shock from the impact of running so that shock is transferred to the Achilles tendon. Use of
inappropriate footwear when playing sport or running e.g., sandals, can also put an extra load on the Achilles tendon. Shoes are now available that have been designed for individual sports and
provide cushioning to absorb the shock of impact and support for the foot during forceful movements. Training on hard surfaces e.g., concrete, also increases the risk of Achilles Tendinitis. Landing
heavily or continuously on a hard surface can send a shock through the body which is partly absorbed by the Achilles tendon. A soft surface like grass turf helps to lessen the shock of the impact by
absorbing some of the force of the feet landing heavily on the ground after a jump or during a running motion.
The main complaint associated with Achilles tendonitis is pain behind the heel. The pain is often most prominent in an area about 2-4 centimeters above where the tendon attaches to the heel. In this
location, called the watershed zone of the tendon, the blood supply to the tendon makes this area particularly susceptible. Patients with Achilles tendonitis usually experience the most significant
pain after periods of inactivity. Therefore patients tend to experience pain after first walking in the morning and when getting up after sitting for long periods of time. Patients will also
experience pain while participating in activities, such as when running or jumping. Achilles tendonitis pain associated with exercise is most significant when pushing off or jumping.
To diagnose the condition correctly, your doctor will ask you a few questions about the pain and swelling in your heel. You may be asked to stand on the balls of your feet while your doctor observes
your range of motion and flexibility. The doctor may also touch the area directly. This allows him to pinpoint where the pain and swelling is most severe.
Relieving the stress is the first course of action. Treatment involves ice therapy and activity modification to reduce inflamation. Active stretching and strengthening exercises will assist
rehabilitation of the gastrocnemius-soleus complex. When placed in a heeled shoe, the patient will immediately notice a difference, compared to flat ground. It is recommended that the patient be
fitted with proper shoes & orthotics to control pronation and maintain proper alignment, relieving the stress on the achilles tendon. Tightness in the tendon itself can be helped by an extra heel
lift added to the orthotics. The patient can expect a slow recovery over a period of months.
As with any surgery there are risks to every procedure depending on a lot of factors, including your age, the severity of your injury and your level of health going into the procedure. It is always
best to discuss all possible risks and complications with your doctor, orthopaedic specialist and/or surgeon before the procedure. It's important to be aware of the risks you may face with any
procedure intended to fix or relieve pain from your Achilles tendon injury.
To prevent Achilles tendonitis or tendonosis from recurring after surgical or non-surgical treatment, the foot and ankle surgeon may recommend strengthening and stretching of the calf muscles through
daily exercises. Wearing proper shoes for the foot type and activity is also important in preventing recurrence of the condition.