characterized by inflammation and pain at the Achilles tendon (back of the ankle). This tendon, sometimes called the heel cord, is the tendon attachment of the calf muscles from the leg and knee to
the heel. This structure is important in standing on your toes or in the pushing-off phase of walking, running, or jumping.Achilles-tendinitis is usually a grade 1 or 2 strain of the tendon. A grade
1 strain is a mild strain. There is a slight pull of the tendon without obvious tendon tearing. (There is microscopic tendon tearing.) There is no loss of strength, and the tendon is the correct
length. A grade 2 strain is a moderate strain. There is tearing of tendon fibers within the substance of the tendon or where the tendon attaches to muscle or bone. The length of the tendon or whole
muscle-tendon-bone unit is increased, and there is usually decreased strength. A grade 3 strain is a complete rupture of the tendon.
The majority of Achilles tendon injuries are due to overuse injuries. Other factors that lead to Achilles tendonitis are improper shoe selection, inadequate stretching prior to engaging in athletics,
a short Achilles tendon, direct trauma (injury) to the tendon, training errors and heel bone deformity. There is significant evidence that people with feet that role in excessively (over-pronate) are
at greater risk for developing Achilles tendinitis. The increased pronation puts additional stress on the tendon, therefore, placing it at greater risk for injury.
Pain in the back of the heel that can be a shooting pain, burning pain or even an intense piercing pain. Swelling, tenderness and warmth over the Achilles tendon especially at the insertion of the
tendon to the calcaneous, which may even extend into the muscle of the calf. Difficulty walking, sometimes the pain makes walking impossible. Pain that is aggravated by activities that repeatedly
stress the tendon, causing inflammation or pain that occurs in the first few steps of the morning or after sitting down for extended periods of time which gets better with mild activity. It is
important to note though that achilles tendinosis can develop gradually without a history of trauma.
During the physical exam, your doctor will gently press on the affected area to determine the location of pain, tenderness or swelling. He or she will also evaluate the flexibility, alignment, range
of motion and reflexes of your foot and ankle. Your doctor may order one or more of the following tests to assess your condition, X-rays. While X-rays can't visualize soft tissues such as tendons,
they may help rule out other conditions that can cause similar symptoms. Ultrasound. This device uses sound waves to visualize soft tissues like tendons. Ultrasound can also produce real-time images
of the Achilles tendon in motion. Magnetic resonance imaging (MRI). Using radio waves and a very strong magnet, MRI machines can produce very detailed images of the Achilles tendon.
Take a course (5 - 7 days) of non-steroidal anti-inflammatory drugs(ibuprofen/voltaren/cataflam/mobic) available from your general practitioner or pharmacist. Apply ice to the Achilles - for 10
minutes every 2 hours, in order to reduce the inflammation. Avoid weight-bearing activities and keep foot elevated where possible. Self-massage - using arnica oil or anti-inflammatory gel. Rub in
semi-circles in all directions away from the knotted tissue, three times a day once the nodule is gone, stretch the calf muscle gently do not start running until you can do heel raises and jumping
exercises without pain return to running gradually full recovery is usually between six to eight weeks.
For paratenonitis, a technique called brisement is an option. Local anesthetic is injected into the space between the tendon and its surrounding sheath to break up scar tissue. This can be beneficial
in earlier stages of the problem 30 to 50 percent of the time, but may need to be repeated two to three times. Surgery consists of cutting out the surrounding thickened and scarred sheath. The tendon
itself is also explored and any split tears within the tendon are repaired. Motion is started almost immediately to prevent repeat scarring of the tendon to the sheath and overlying soft tissue, and
weight-bearing should follow as soon as pain and swelling permit, usually less than one to two weeks. Return to competitive activity takes three to six months. Since tendinosis involves changes in
the substance of the tendon, brisement is of no benefit. Surgery consists of cutting out scar tissue and calcification deposits within the tendon. Abnormal tissue is excised until tissue with normal
appearance appears. The tendon is then repaired with suture. In older patients or when more than 50 percent of the tendon is removed, one of the other tendons at the back of the ankle is transferred
to the heel bone to assist the Achilles tendon with strength as well as provide better blood supply to this area.
If you're just getting started with your training, be sure to stretch after running, and start slowly, increasing your mileage by no more than 10% per week. Strengthen your calf muscles with
exercises such as toe raises. Work low-impact cross-training activities, such as cycling and swimming, into your training.