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Achilles pain

Haven’t I heard the name “Achilles” before?

You’ve probably heard the name “Achilles” if you’ve ever studied Greek mythology. According to myth, Achilles was a legendary warrior in Agamemnon’s army during the Trojan War. He was known far and wide for his good looks and bravery.

It is said that his mother dipped Achilles into the River Styx to make him invulnerable. Unfortunately, the water didn’t touch the part of his heel by which his mother held him, leaving him with a point of weakness. Achilles was ultimately killed during the War when a soldier learned about his imperfection and shot a poisoned arrow into his heel. Today the expression “Achilles’ heel” has come to refer to a vulnerability or targeted flaw of some sort. The tendon that extended into the infamous Achilles’ heel is now known as the Achilles tendon.

Achilles statue foot

What does the Achilles tendon do?

Tendons are connective tissues that connect muscles to bones. The Achilles tendon connects the calf muscles in the back of your leg to the heel bone. This particular tendon works with nearby muscles to help you push off with your feet or push up on your toes. That means that you are constantly using your Achilles tendon when walking, running, jumping, etc.

What is Achilles tendinitis?

Achilles tendinitis is a common injury in which the Achilles tendon stretches, tears, or becomes otherwise irritated. It can be a chronic condition, or strike suddenly during rigorous use.

What causes Achilles tendinitis?

It can be caused by overuse of the tendon, weak or tight calf muscles, arthritis, or even just the normal aging process. This injury is especially common in middle-aged adults who don’t exercise on a regular basis, since the tendons are weakened from years of use and are also rigid/inflexible from lack of stretching. It can also be caused by frequently running on hard surfaces, frequently running or jumping in general, wearing unsupportive footwear, and/or sudden injuries that involve twisting your foot. Pre-existing injuries or deformities, like bone spurs or flat feet, can cause tendon irritation as well.

What are the symptoms of Achilles tendinitis?

The tendon will be swollen and painful along its length, as well as near the bottom of the foot and heel. The region may be stiff and tender to the touch. Heat will likely be localized in the area due to the inflammation. Activities involving the tendon, such as walking and running, may become difficult and painful. You will likely have difficulty pushing up on your toes or stretching your calf muscle. If the tendon ruptures then you will experience a sharp pain, as though someone has whacked you on the back of your heel with a stick.

How is Achilles tendinitis diagnosed?

A physical exam is usually enough to diagnosis Achilles tendinitis. The healthcare professional will press along the length of the tendon to check for tenderness and pain. They may ask you to attempt pushing up on your toes to see if your movement is impaired. If they think the injury might be the result of a bone problem they may order an X-ray. If the injury is likely caused by a tear or in the tendon, or if you want to consider your surgical options, then you may need to have an MRI scan.

Achilles tendinitis diagram

How is Achilles tendinitis treated?

This is a debilitating injury that will likely be painful for at least 2 or 3 months. Athletes who receive this diagnosis generally have to take the remainder of their season off and commit themselves to healing. Treatment usually involves physical therapy and regular stretching exercises throughout the day. Ice packs can be applied to the affected area to decrease swelling and pain. Keeping the heel elevated will help to decrease swelling as well and may speed up the healing process. You may need to wear a foot brace, boot, or cast to keep the area immobilized during the restoration process. If not, you will probably still need to wear softer shoes or footwear that dedicates special support to the heel. You should alter any activities that cause you pain and try to put as little stress on the Achilles tendon as possible throughout the day. Non-steroidal anti-inflammatory drugs like ibuprofen or steroid injections may be used as needed for the pain and swelling.

If these main treatment options don’t work then you may need to undergo surgery to remove the abnormal areas of tendon and local inflamed tissue. Bone abnormalities such as heel spurs may be corrected using surgical methods as well.

Can I prevent Achilles tendinitis?

You can reduce your risk of Achilles tendinitis by exercising regularly without over-exerting yourself. Certain leg exercises and stretches are useful for keeping your calf muscles flexible and strong, which makes the possibility of injury less likely. Also, you should always warm up using non-static stretches before exercising to make sure you loosen up the muscles before pushing them.


Sources Cited

https://www.nlm.nih.gov/medlineplus/ency/article/001072.htm

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0024961/

http://www.britannica.com/topic/Achilles-Greek-mythology

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