Introduction 

The Achilles tendon connects the gastrocnemius and soleus muscles of the calf to the heel bone. The Achilles tendon is the longest and strongest tendon in the body, which is essential for walking, running, jumping, and other functional movements. Tendinitis is a common condition in which the tissue becomes inflamed from repetitive strain. This can happen with any muscle or tendon in your body, but tendinitis of the Achilles is one of the most common reasons for foot and ankle pain. 

Achilles Tendonitis, also known as Achilles Tendinopathy or Achilles Tendon Rupture, is a condition in which the tendon that connects your calf muscle to your heel bone becomes inflamed. This inflammation can be caused by the overuse of the tendon. It is common for people who do a lot of running, jumping, or competitive dancing to develop this condition. Anyone at risk for this condition should be aware of symptoms, treatment options, and how to prevent it from happening again.

Symptoms of Achilles Tendonitis

The major symptom of Achilles Tendonitis is swelling and pain in the back of your heel when you run, jump, or walk. Other symptoms include a limited range of motion when you try to move your leg and tight calf muscles. Other common symptoms include:

• The skin on the back of your heel becomes warm when touched
• Pain on the tendon or back of the heel that worsens with actions.
• Severe pain after exercise
• Stiffness and pain on the Achilles tendon when you wake in the morning.
• Swelling that gets worse with actions.
• Thickening of the tendon.

 Causes of Achilles Tendonitis

Achilles Tendonitis is caused by activities where you start movement immediately as you push up and lift your foot instead of when you land. It is common among people who engage in activities where they pivot, quickly speed up, or slow down such as volleyball, basketball, baseball, dancing, running, tennis, softball, football, and gymnastics. For example, an athlete might get injured at the start of a race as they push off the starting block because there is a sudden abruption in the activity of the tendon, and it might be too much for the tendon to handle.

Risk Factors of Achilles Tendonitis

Here are some of the factors that may increase the risk of Achilles Tendonitis;

• Achilles Tendonitis is more common in men; therefore every man are at higher risk
• The more you age, the more the increase in the risk of Achilles Tendonitis. This is because your tendon gets weaker as you grow
• If you have a flat arch in your foot, you are at more risk. This is because your flat arch puts more pressure on the Achilles tendon.
• Also, if you are obese, you are at a higher risk. This is because your weight will exert too much pressure on the tendon.
• Some antibiotics medications like fluoroquinolones can increase the risk of Achilles Tendonitis
• Using improper or worn-out footwear can increase the risk of Achilles Tendonitis.
• Individuals who train under cold weather very frequently than they do in warm weather have a high risk of having Achilles Tendonitis
• Individuals who wear high heels have a high risk of having Achilles Tendonitis. This is because the heels exert stress on the tendon
• People with tight tendons or tight leg muscles also are at risk of having Achilles Tendonitis
• Individuals who work out on an uneven surface are also at high risk of having Achilles Tendonitis.

Prevention of Achilles Tendonitis

The following measures can help reduce the risk of Achilles Tendonitis, even if it is not possible to prevent it.

Cross-train: Alternate your high-impact training activities like jumping and running with low-impact activities like swimming and cycling.

Stretch daily: Take your time to stretch your Achilles tendon and calf muscle daily in the morning. Also, stretch before exercises and after exercises. This is important because it helps you maintain flexibility and avoid relapse of Achilles Tendonitis

Increase Your Activity Gradually: If you are starting a new exercise procedure, start gradually and slowly; then increase the pace and duration as time goes by.

Strengthen Your Calf Muscle: With a strong calf muscle, the calf tendon and Achilles tendon become stronger to handle the stress exerted on them during activities. Strengthen your calf muscle with calf-related exercises.

Wear Proper Footwear: Wear proper shoes, especially during exercises. The shoes should have enough cushions for your heel and should support your arch firmly. This will help minimize the tension in the Achilles tendon. Furthermore, replace worn-out footwear. If you have good footwear, but the support is not enough, you can get a good insole to make it better.

Know when to stop: Whenever you feel pain at the back of your heel, stop all activities. Also, cut down on uphill running when you feel tightness in the back of your heel.

Diagnosing Achilles Tendonitis

Sometimes, Achilles Tendonitis is mistaken for a sprained ankle. To diagnose Achilles Tendonitis, your doctor will perform a physical examination and request you walk or run, so they can determine the possible problem that might have caused the injury. The doctor may also ask few questions about the swelling and pain in your calf or heel.

The doctor may perform a calf squeeze test where you will be required to lie on an examination table or kneel on a bench or chair; the doctor will then gently squeeze the calf muscle on your injury-free leg, this squeeze will pull the tendon muscle and make your foot move. After that, the doctor will repeat the same procedure on your injured leg, if your Achilles tendon is injured, your leg will not move because the foot and calf are not connected.

The doctor may also request some tests to confirm Achilles Tendonitis. The tests include X-ray, Magnetic Resonance Imaging (MRI) Scans, and Ultrasounds tests.

Treatment of Achilles Tendonitis

Achilles Tendonitis can be treated with surgery and nonsurgical procedures. Nonsurgical treatment procedures may effectively subsidize the pain after 3 months, but if the pain has been there several months before the commencement of treatment, it may take up to 6 months before the pain subsidize effectively. Here are the treatment procedures of Achilles Tendonitis

Rest: The tendon heals faster if no extra weight is exerted on it during the treatment time. Do not exert weight or pressure on your weight until you can walk on the tendon without pain. If you need to go long distances, it is best advised to get crutches.

Ice: Icing of the affected area usually makes swelling or inflammation go down faster. Put ice in a bag and wrap it in a cloth. Put the wrapped ice on your skin; keep the ice on the skin for about 15 to 20 minutes. Alternatively, you can get ice inside a water bottle

Compression: Put a cloth, athletic wrap, or bandage around the affected area to compress the injury. This stops the tendon from further swelling; ensure not to tie too tight, so as not to disrupt the flow of blood

Elevation: While lying down, raise your foot above the chest level. This is done to minimize the swelling of the injury.

Use of Supportive Shoes: While recovering, wear a recommended shoe insert. This will protect your Achilles tendon from further swelling and stretching. Wear shoes that are softer at the back of the heel. Also, Shoe lifts are helpful, as they help take the strain off the tendon.

Take Anti-Inflammatory Painkillers Medications: Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) such as naproxen and ibuprofen can reduce swelling and pain. Ensure to get usage recommendations and prescriptions from medical personnel. 

Practice Strengthening and Stretching Exercises: As recommended by your physical therapist or doctor, ensure to practice strengthening and stretching exercises.

Extracorporeal Shock Wave Therapy (ESWT): This procedure is mostly tried before surgery is recommended. ESWT helps reduce pain and inflammation by using high-energy shockwave impulses to enhance and fast-track the healing process of damaged tendon muscles.

Surgery: In a severe case where all the fore-mentioned treatment procedures do not give the required result, surgery may be required. Based on the severity of the pain, a surgeon will determine the best procedure for you.

Conclusion

Achilles Tendonitis if not treated on time can require surgery. Immediately you notice pains or swelling in your heel, visit your doctor for proper diagnosis.

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