Achilles Tendon Pain

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					Achilles Tendon

A most strong, large and thick tendon in human body, which links the calf muscles
(gastracnemus and soleus) to the heel bone (calcaneus) is termed as Achilles Tendon. Its
key function is to lift the heel or push it off during normal activities.

What is Achilles Tendonitis?

Normally, Achilles Tendon can manage forces upto some extent (1000 pounds or more).
If it crosses its limit or is subjected to extreme stress, it becomes tight and hurtful.
Damage to Achilles Tendon causes severe foot pain and disorder in lower leg. This is
referred to as Achilles Tendonitis.



Symptoms and Causes of Achilles Tendonitis

Symptoms:

      Pain after stretching exercise and
       severe pain in course of time.
      Irritation and intolerable pain over the
       heel.
      Development of pain after sitting for a
       long time.
      Feeling of toughness of tendon, when
       you touch the back leg near heel.
      Severe pain at the exact origin point on
       the tendon inserts.
      Pain after stretching exercises in the
       early morning.
      A clear sense of idleness (laziness) in
       your leg.
      Mild swelling and stiffening about half
       an inch above the region where
       Achilles Tendon is connected to heel
       bone.

Causes:

      Overuse of Achilles bone is the common cause for Achilles Tendonitis.
      People who increase their running speed continuously with sudden acceleration.
      Decrease in natural flexibility of the calf muscles.
      Replacing the height of footwear (boots to high-heel, low heel to stiletto) at
       irregular intervals.
      Wearing high heels for a long period of time.
      Jogging/walking on different surfaces.
      Lack of adequate cushioning and stability in footwear during heel strike.
      Doing exercises without proper warm up and stretching.
      Involving in new type of sprinting and hill running.
      Wearing improper orthotics.

Classification:

Depending upon the area of pain over Achilles Tendon, the disorder can be classified into
two types: (i) Acute or Non-insertional Achilles Tendonitis (ii) Chronic or insertional
Achilles Tendonitis.

(i) Acute Achilles Tendonitis.:

Pain developed towards the point of origin of Achilles Tendon is said to be Acute
Achilles Tendonitis. Normally, moderate pain arises abruptly 2-6 cm above Achilles
Tendon inserts. This sharp ache occurs during beginning of any activity and later
becomes severe due to extreme stress on Achilles Tendon. There are three levels of Non-
insertional Tendonitis.

Level-I (Achilles Peritendinitis)

In this stage, a slight/normal distortion occur on Paratenon and nearby sensitive tissue
‘bursa’. Paratenon - An areolar tissue present between tendon and tendon sheath. Bursa -
A tiny fluid-filled sac situated between joints.

Level-II (Peritendinitis)

If you analyse the tendon at this phase, the changeable amounts of necrosis (death
cells/tissues), longitudinal tears, tendon rupture can be seen. This is because, severe
swelling of the paratenon lead to enzyme degradation.

Level-III (Achilles tendinosis)

When there is degeneration of proteins in tissues at the Achilles bone joint, it leads to a
serious problem often referred as ‘Achilles Tendinosis’.

Chronic Achilles Tendonitis:

Chronic Achilles Tendonitis is a problem/swelling at the front end of the tissue joining
the heel bone (calcaneus) which results in enlargement of posterior heel or tendon. This
type of Achilles tendonitis has got peculiarity compared to the acute tendonitis by the
nature of pain caused. This is because acute tendonitis creates pain at a specific point at
the tendon but Chronic Tendonitis develops pain mostly on the back side of heel where
Achilles bone starts.