What is it?
Achilles tendonitis is inflammation and pain in the back of the ankle. The Achilles tendon attaches the ankle to the calf muscles and is critical for the push-off motion in walking, running and jumping. Achilles tendonitis can be caused by a sudden increase in activity, overuse of the lower leg muscles, or from a direct blow or injury to the lower leg or foot.
Figure 1: Achilles Tendon
(Safran et al, 2003.)
What are the symptoms?
- Pain and tenderness over the Achilles tendon
- Pain with ankle motion, especially pushing off or pushing down on the front of the foot
How is it treated?
- Initially, ice and anti-inflammatory medications are recommended to relieve the pain. Then, stretching and strengthening exercises, and modification of the activity that caused the problem. (See next page for exercises.)
- Physical therapy, if preferred
- Heel lift or orthotics to relieve the pressure on the tendon
- A walking boot to immobilize the tendon
- Surgery to remove the inflamed tendon lining or degenerated tissue
How is it prevented?
- Warm up and stretch before activities
- Rest between activities
- Maintain conditioning such as ankle flexibility, muscle strength and endurance, and cardiovascular fitness
- Use proper technique for all activities
What are potential complications?
- Healing time may be prolonged and symptoms may return if the injury is not given adequate healing time before returning to all activities.
- Untreated tendonitis may result in tendon rupture.
Range of Motion and Stretching Exercises
Start slow with these exercises, progress until you feel a gentle stretching sensation. Each stretch should be held for 20 to 30 seconds. These exercises should not increase your pain, even the day after exercise.
- Gastrocsoleus Stretch I
Stand facing a wall. Put your hands on the wall with the leg to be stretched behind you. With your toes pointing forward, lean toward the wall while keeping your heel on the floor. First, keep your knee straight. Then, bend the knee slightly.
- Gastrocsoleus Stretch II
Place your toes and the ball of your foot on a book or the edge of a stair. Your heel should be off the ground. Hold on to a chair or stair rail for balance. Allow your body weight to stretch the calf and Achilles tendon. First, do this exercise with your knee straight. Then, bend the knee slightly and perform the exercise.
- Plantar Flexor Strength I
Loop elastic band or towel around the bottom of your foot. Pull the band toward you. Push your toes away from you slowly. Hold for several seconds, repeat several times.
- Plantar Flexor Strength II
Stand on the edge of a step. With your body weight on the front of the foot, raise your position with your knee straight. Lower the heel of the injured side below the level of the step. Rise back up to the level of the step, using the uninjured leg if you need help. Work up to three sets of 15. You can advance this exercise by bending the knee of the injured leg slightly or by wearing a backpack with weights inside.
Figure 2: Gastrocsoleus Stretch I
(Safran et al, 2003.)
Figure 3: Gastrocsoleus Stretch II (Safran et al, 2003.)
|Figure 4: Plantar Flexor Strength I (Safran et al, 2003.)|
Figure 5: Plantar Flexor Strength II (Safran et al, 2003.)
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