The human body has a part that is repeatedly exposed to great stress – the feet. In this way, Achilles tendonitis has been given special importance in recent years.
What is Achilles tendinitis?
Typical problems with the Achilles tendon. The Achilles tendon connects the terminal tendons of the soleus and gastrocnemius muscles with the calcaneal tuberosity. Click to enlarge.
The different perspectives of the explanation of an Achilles tendonitis represent a pathological change in the area of the Achilles tendon . This is based on a painful inflammatory reaction, which can severely restrict the person concerned in his freedom of movement. There are many causes for inflammation of the Achilles tendon.
In most cases, the physical strain is particularly high. Significant injuries to the tendon area can occur in this way . Inflammation of the Achilles tendons occurs quite often, especially in athletes. But shoes also play a major role in the development of inflammatory reactions in the area of the Achilles tendons. Very often women wear shoes with very high heels. Long-term use of shoes that are not suitable for the feet can shorten the Achilles tendons.
Often the cause of an inflammatory reaction lies in poorly developed muscles in the calf area. Care should be taken to train these muscle areas adequately. The so-called clubfoot is also one of the risks for the occurrence of an Achilles tendonitis with all the painful symptoms and complaints.
Due to various misalignments of the feet, the Achilles tendons are also shortened. Appropriate treatment can be given if the symptoms of the inflammatory response in this area are correctly identified.
Tendonitis is mainly diagnosed by specialists in the field of orthopedics . But physicians from the sports sector can also be consulted.
Symptoms, ailments & signs
In the case of Achilles tendonitis, the pain initially only occurs in the morning and disappears after a few movements. In the course of the disease, the symptoms persist in phases of rest or at night and do not go away completely during the day. In addition to the pain, there may be swelling, reddening of the skin and itching in the heel area.
These symptoms usually cause the affected foot to be restricted in movement: Tension pains and the typical burning sensation occur when moving. The swelling can also increase. If the Achilles tendonitis is treated quickly, there will usually be no further symptoms. If no treatment is given, achillodynia can develop .
This manifests itself, for example, in a stiffening of the Achilles tendon in the morning and chronic pain that radiates to the rear lower leg and to the heel . The Achilles tendon is swollen, very warm and reddened, and touching it causes severe pain. Achilles tendinitis can also damage nerve endings and cause microcracks.
After an operation, symptoms such as swelling in the tarsal and ankle area can occur, but this usually subsides after a few days. The symptoms mentioned often persist for several weeks to months, even with early treatment.
Diagnosis & course
To diagnose Achilles tendonitis, the doctor will take a medical history. Different questions about the patient’s everyday life and his complaints are discussed. These then mainly concern the time of the complaints, possible sports and previous illnesses.
Then the person concerned is physically examined. The doctor will first perform an apparent examination and scan the Achilles tendon. Changes in this area can then usually be felt. If there are inflammatory reactions to the Achilles tendons, the doctor may also use an imaging test. Most often, an ultrasound device is used here to make a diagnosis .
But X-rays can also be used to show inflammation in the Achilles tendons. In this way the disease can be represented very well. The course of the disease can last a very long time. This is often due to the fact that those affected do not always take the symptoms seriously and do not consult a doctor.
In the beginning, the pain mainly occurs in the morning and subsides after some movement. As the disease progresses, the symptoms also occur at night or when the patient is resting. Ultimately, achillodynia develops . This leads to a degeneration of the Achilles tendon, which can also affect the surrounding tissue such as nerves and vessels.
If left untreated, the course of the disease can be protracted, especially if those affected ignore pain in the Achilles tendon and maintain the stresses of everyday life and their sporting behavior. The pain usually occurs in the morning after getting up. After the patient has been moving for a few minutes, the symptoms quickly subside. However, as the disease progresses, the pain also occurs at night or at rest.
Other complaints are overheating, sensitivity to pressure and hardened calf muscles. Achillodynia can develop if the diagnosis of Achilles tendonitis is too late. This is difficult to treat because severe degenerative changes occur in the Achilles tendon and the surrounding tissue.
These include newly formed blood vessels and nerve endings as well as microcracks. Several months pass before the patient can move around again without pain and without restriction. One of the common but harmless symptoms of Achilles tendonitis is swelling in the tarsal and ankle area, which, however, subsides a few days after the operation.
Wound infections and inflammation or pain in the scar tissue are also possible. These wound healing disorders are mostly due to an ulcerated and differently pigmented scar. A deep soft tissue infection is also feared. This arises in the area of the surgical site and destroys the sutured tendon again.
A follow-up operation is necessary. Serious complications include injuries to nerves in the Achilles tendon that cause numbness on the outside of the foot. More rarely, a new tear occurs after a surgical suture or with conservative therapy.
Treatment & Therapy
Furthermore, it is highly recommended to use cooling aids for the treatment of Achilles tendonitis. These are also used in what is known as cryotherapy . The aim of this form of treatment is to reduce swelling in the Achilles tendon area.
Very often there are noticeable improvements in symptoms after the first few treatments. If the inflammation of the Achilles tendon is caused by a shortening of the tendons, specially made shoes can also be worn. These shoes have small heels. But various bandages that have a relieving effect can also be used. Furthermore, it is possible to use appropriate shoe insoles for a successful therapy for Achilles tendonitis .
These are now becoming increasingly popular. These insoles can help correct the deformed feet. So-called kinesio tapes are also very often prescribed. These special tapes help the inflammatory reaction in the Achilles tendons to heal very quickly. In this way, the disease can even be prevented.
Outlook & forecast
The Achilles tendonitis leads to relatively severe pain and restrictions in movement. For some people, restricted mobility can also lead to depression or other psychological complaints and thus have a negative effect on quality of life. There is also severe swelling of the affected area and reddening of the skin.
In severe cases, the patient has to rely on a walking aid when the restriction of movement has progressed. Physical and sporting activities are no longer easily possible due to the Achilles tendonitis.
Diagnosis of Achilles tendonitis is easy in most cases, so treatment can be started quickly. As a rule, the patient then has to take care of his body and should no longer exercise for a certain period of time.
Sometimes the pain also occurs in the form of resting jokes and can also lead to sleep disorders. Inflammation and pain are combated with the help of medication. However, if the treatment comes late, the symptoms can usually no longer be completely limited. Life expectancy is not reduced by the disease.
Anyone who wants to counteract the occurrence of inflammation in the Achilles tendons should make sure that the physical strain on the feet is not too high. In this regard, it is also very important that the physical strain does not occur one-sided, as this situation in particular has extremely negative consequences.
If there is regular or frequent stress on the feet, tendons and joints, it is essential to ensure that these are evenly distributed. It is also very important that suitable shoes are worn.
So that no complaints can arise in the first place, it is essential to clarify whether there are any misalignments in the foot area. Sometimes this is not necessarily noticeable to the layman and does not necessarily have to lead to complaints. If this is the case, a suitable therapy should take place as soon as possible.
Achilles tendinitis is an often protracted symptom that can flare up again and again. Consistent aftercare is therefore particularly important. The right contact persons for this are the family doctor, the sports doctor or the orthopedic surgeon.
The protection of the Achilles tendon after the therapy and the subsidence of the symptoms is the top priority. Too early exercise, especially with athletes, is to be avoided at all costs if the regeneration is to proceed optimally. A step-by-step approach to the burden and listening to your own body are prerequisites. This also includes stretching before and after exercise.
The focus here is on the calf muscles. These muscles can also be massaged regularly. This ensures that the muscles of the calf do not cramp and therefore do not exert a high tensile effect on the Achilles tendon. The patient learns about the stretches that are particularly relevant from the physiotherapist.
The right footwear is also very important when it comes to proper aftercare for Achilles tendonitis. The heels should be chosen rather low, as high heels shorten the calf muscles and irritate the Achilles tendon area again. Elevating the feet after exercise can help the Achilles tendon to recover. Walking barefoot contributes to the physiological stress on the feet and is also a helper in the context of aftercare after surviving Achilles tendonitis.
You can do that yourself
Achilles tendinitis must always be treated by a doctor. In addition, the symptoms can be alleviated with some home remedies and measures.
First, the inflamed Achilles tendon should be relieved and cooled. Repeated massages with ice cubes or cooling ointments from the pharmacy are particularly effective . Pain reliever and anti-inflammatory home remedies such as mint , valerian , cinnamon or lavender can be applied to the tendon in the form of ointments, oils or compresses and promise rapid pain relief. Foot baths with essential oils and other agents that promote blood circulation are also suitable . There are also classic massages and relaxation exercisesat. In the event of severe discomfort, you should temporarily switch to protective footwear with a footbed.
To accelerate the healing process, heat therapy and light stretching exercises for the flexor muscles of the thigh are also recommended . An effective exercise is repeated bobbing up and down with toes and heels on a step. In addition, alternative remedies such as direct current therapy or treatment with ultrasound are also available. If you have more severe complaints, you should see a doctor or an orthopedic surgeon immediately if you have an inflammation of the Achilles tendon .