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Header: Achilles Tendon Conditions

Achilles Tendon Conditions

Achilles tendon conditions belong to among the most common overuse injuries of the active population and athletes. Prevention and an optimal timely treatment, help to prevent permanent damage. What can cause an Achilles tendon condition?


What can cause an Achilles tendon condition?

The Achilles tendon is the largest and strongest tendon in the human body. Especially during sports activities it is subject to enormous stress. Overuse and stress due to sports activities lead to micro-injuries in the tendon tissue, which can, however, be compensated by endogenous repair mechanisms when the load does not exceed the load limit of the tendon. Because of their length and thickness, the blood supply and thus the nourishment of the tendon isare naturally critical. The Achilles tendon is encased in a delicate, multi-layered sliding tissue. Problems occur most commonly at the slider tissue or poorly perfused middle third of the Achilles tendon. The following factors may have a damaging effect on the Achilles tendon:

  • inappropriate, worn out footwear
  • axis deviation in the ankle (flat feet/ fallen arches, hyperpronation)
  • running on hard ground (concrete, tartan tack) or uneven ground (sand, pot holes)
  • sudden jerking motions (jumps, sprints, abrupt stopping and twisting movements, etc.)
  • permanently shortened or overstretched calf muscles (muscular dysbalance)

What are the symptoms of Achilles tendonitis and how is it diagnosed?

Typical of an Achilles tendonitis is the pain when straining the leg, but also pain already occurring in the morning after getting up. You may also feel pain during or after prolonged exercising. Often the paratenon (sliding tissue surrounding the tendon) is tender to touch and swollen. With an acute tendonitis, you can feel a grating directly above the tendon when raising and lowering the foot. In chronic irritations, the Achilles tendon often shows a piston-like swelling in the middle. For an accurate diagnosis, the experienced sports physician will, in addition to a comprehensive physical examination, assess the injury with laboratory examinations such as ultrasound or MRI.
Why is it so important to treat an Achilles tendon condition?

Achilles tendonitis tends to become chronic, i.e. cause permanent complaints. Consequently, it is essential to start the treatment as early as possible. The longer the Achilles tendon irritation persists, the harder it is to cure. In addition, chronic Achilles tendon irritation will most likely lead to a rupture of the Achilles tendon.

What can I do when I feel pain in the Achilles tendon?

Even if it is annoying, the stress on the irritated tendon must be reduced immediately! However, this does not mean that you can no longer participate in sports. It means that you take a break for a few days from sport activities, and instead of intensive running, carefully train in activities like cycling, skating, or aqua jogging.

In the acute phase, meaning if you experience severe pain, the irritated tendon should be treated with a mild cold pack for two to three days (cold pack for about 15 minutes, several times during the day). Anti-inflammatory creams or ointments, curd wraps are also helpful. As soon as the acute pain has left, treatment should continue with a massage to support the blood circulation and the self-healing process of the tissue. Also helpful are hot wraps, warm leg baths, and applying ice for 10 -12 minutes. Stretching the calf muscles intensively, the chronic strain on the Achilles tendon should reduce the strain, at least preliminary, and support the self-healing process.

What other treatments can be helpful?

To optimize the healing process, physiotherapy treatment is usually very helpful. Measures such as cross friction, ultrasound, electrical stimulation, laser, etc., should improve the metabolic status of the tendon and lead to a quick recovery. Targeted physiotherapy will adjust muscular imbalances and support stretching exercises.

An infiltration treatment (injections) in the sliding tissue may be an option in the treatment. Recommendations are to primarily use biological substances. Only in the case of an acute inflammation, a short-term corticosteroid therapy is indicated. Immobilization of the Achilles tendon is based on experience, not very successful. However, temporarily increasing the heel on the shoe from about 0.5 to 1.5 cm contributes to the relief of the Achilles tendon.

The benefits of other conservative treatments such as shock wave therapy, X-ray irradiation stimulus, acupuncture or neural therapy is a matter to be discussed between the patient and the treating physician.

If conservative treatment fails, the possibility of operative procedures may be taken into consideration. In a surgery, the chronically irritated or damaged tendon paratenon parts are removed. However, surgery is only recommended if a conservative treatment does not effectively relief the symptoms.

What can I do to prevent Achilles tendon problems?

Even if it appears time consuming for many athletes: Preventive measures are regular stretching and loosening of the calf and thigh muscles! Before and after exercising, athletes should take at least five minutes to go through a well-planned stretching routine. Additionally, there should always be sufficient recovery periods after intense workouts. Often, a treadmill analysis is useful to determine what running shoes are appropriate or how to optimize the running movements by using special inserts. With any kind of Achilles tendon problems, an experienced orthopedist should be consulted to analyze the exact cause and to initiate an optimal therapy.

Who specializes in the treatment of Achilles tendon conditions and injuries?

The orthopedic team at the KLINIK am RING specializes in the treatment of all sports injuries, conditions, and diseases. The team relies on a founded expertise and comprehensive experiences and also offer consultation regarding professional treatment options and methods to amateur athletes.

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