Symptoms Achilles tendon has no real tendon sheath, but is surrounded by peritendinous tissue (fat space tissue separating tendon and tendon sheath). The early pain of achilles tendinitis is mainly caused by the injury of peritendinous tissue. When the patient gets up or walks continuously, the activity of tendon in peritendinous tissue increases, so the pain is aggravated, and the pain will be aggravated during training. Pressing the achilles tendon with your fingers feels tender.
Typical symptoms:
1. Pain, soreness, tenderness and stiffness above and inside the heel, aggravated after exercise. It may occur anywhere in the achilles tendon, and the pain usually occurs in the early morning or during the rest after strenuous exercise.
2. There will be intense pain or tenderness when the two tendons are squeezed.
3. When the lesion gets worse, the tendon will swell and nodules will appear in the lesion area.
Injury mechanism Achilles tendon is a big tendon located behind the ankle joint, which connects the muscles behind the calf and the calcaneus. It is an indispensable tool for human walking, running and climbing. Excessive use due to various reasons will lead to chronic injury of fibers in achilles tendon, such as overload exercise, frequent running on hard ground such as roads, mountain climbing, etc. , can lead to tendinitis. About 1 1% patients have tendinitis due to sports injuries such as running. However, Achilles tendon often heals slowly due to insufficient blood supply.
Symptoms:
Acute achilles tendinitis
1. Achilles tendon pain during walking, running and other sports.
2. Achilles tendon swelling
The skin at achilles tendon is red and hot.
chronic phase
1, Achilles tendon pain or stiffness often occurs in the early morning.
2. Walking, especially climbing mountains and going upstairs, will cause achilles tendon pain.
3. Chronic tendinitis lasts for a long time. The cause of Achilles tendinitis Achilles tendon is a band-like tissue connecting calf gastrocnemius and calcaneus. People need it when walking, running, jumping and walking on tiptoe. When the pressure on the achilles tendon is too high in a short time, it may be slightly torn, and then inflammation may occur.
In addition, other reasons may also lead to achilles tendinitis, including:
1, physically inactive or not adjusted. If you are unwell (such as lack of flexibility and strength of gastrocnemius muscle), you are not active or adjusted well, especially basketball, tennis and other sports that need to stop, jump and jump frequently, it is easy to cause Achilles tendinitis.
2. Exercise too much and too often. If you just start a new exercise plan, you must stretch before and after exercise. Start activities slowly, gradually increase the amount of exercise, and don't pursue progress too much. If you do running, too much uphill running is more likely to lead to achilles tendon inflammation.
3. Flat feet and flat feet will increase the risk of achilles tendinitis, because when walking, flat feet will cause extra pressure on the achilles tendon. If it is flat feet, it is best to wear shoes with arch support to avoid further deterioration of achilles tendon.
4. Trauma or infection In some cases, inflammation of achilles tendon is caused by trauma or infection near achilles tendon.
Clinical diagnosis of achilles tendinitis In order to diagnose achilles tendinitis, doctors need to examine the foot and possibly X-ray the achilles tendon to rule out other diseases that may cause achilles tendon pain. In addition, the doctor may ask about the activities. If the doctor suspects that the Achilles tendon is broken, he may have a magnetic resonance imaging (MRI) scan, which is a painless examination that uses a magnetic field to display an image of the soft tissue of the body.
Treatment Under normal circumstances, achilles tendinitis will be improved after a period of self-care (such as rest, ice compress, taking over-the-counter painkillers, etc.). ). If it doesn't work, the doctor may suggest other treatments, including:
1, using the support pad, the support pad can raise the ankle and reduce the stretching of the achilles tendon. The doctor may also let you use a splint to fix the achilles tendon when you sleep at night.
2. Wear walking boots or use crutches. If the condition is serious, the doctor may suggest wearing walking boots or using crutches to help heal the achilles tendon.
3, surgical non-surgical treatment (including physical therapy) can often make Achilles tendinitis heal and repair itself within a few weeks. If these treatments fail, surgery may be needed to remove the inflammatory tissue around the achilles tendon. However, this is often the last resort.
Selection of anti-inflammatory and analgesic drugs for external use.
1, athletes should stop running and pad their heels to reduce the tension of achilles tendon. As long as it does not cause pain, they should strengthen the elastic exercise of N-rope muscles and wear soft-soled shoes to ensure the flexion of 1 metatarsophalangeal joint, but the heels should be hard. If there is no pain in the achilles tendon, you can do toe lifting exercise to increase the muscle strength of the achilles tendon. Avoid running up and down quickly before achilles tendon heals.
2, cold compress.
3, according to the need to use orthosis or change the way of movement.
4. Physical therapy is the key. The key method is to stretch gastrocnemius muscle when knee joint is straight and soleus muscle when knee joint is slightly flexed. Strength training, ultrasonic therapy and electrical stimulation therapy can also be applied to physical therapy. Anti-inflammatory drugs can accelerate recovery. Plastic surgery with heel lifts can sometimes help relax the achilles tendon. A night splint that holds the ankle in a natural state (90 degrees) can help you prevent the calf muscles from tightening. In some serious cases, it may be necessary to use some instruments to reduce the tension on the Achilles tendon when walking.
5. Local sealing can relieve pain, and other treatments are needed to avoid repeated sealing leading to achilles tendon rupture. Active treatment after diagnosis can be seen through local drug injection. Such as triamcinolone acetonide injection.
6. Personalized rehabilitation plan.
7. If we pay attention to the treatment of this injury in the early stage, we will have a better prognosis. However, when early injury is neglected, it is very difficult to treat chronic achilles tendinitis.
Although disease prevention cannot completely prevent the occurrence of achilles tendinitis, some measures can be taken to reduce its risk:
Exercise should be gradual, and gradually increase the amount and intensity of activities. Avoid sports that will put too much pressure on the achilles tendon, especially sports that take too long. If you feel pain in an activity, you should stop and have a rest immediately. The shoes you wear during exercise should fit your feet, provide sufficient cushioning for your ankles, and have solid arch support to help reduce the pressure on your achilles tendon.
Stretch every day, especially in the morning, before and after exercise, and stretch the gastrocnemius and Achilles tendon to maintain the toughness of Achilles tendon. This is especially important to avoid the recurrence of achilles tendinitis. Doing some exercises that can strengthen the gastrocnemius, such as "tiptoe exercise", that is, standing on tiptoe and falling slowly, can enhance the achilles tendon muscle to bear more loads.
1, warm up and stretch well before exercise. When the muscles and bones move separately, the calf muscles are too tense or too tired, then the impact force generated by the exercise will be transmitted to the achilles tendon, which may cause achilles tendinitis.
2, strengthen strength: high-load calf exercise can make the achilles tendon bear more strength.
Physical strength strengthening: Intensive training can improve the movement level of muscles, tendons and ligaments of calf and ankle joint.
Stretching: Leg stretching can improve the flexibility of tendons.
Balance ability: do some exercises to improve your balance ability and exercise your sense ability.
3, choose the right shoes, if the shoes are too big, people tend to bend their toes to hold the soles, this action will overuse the plantar aponeurosis and related tissues, leading to local tendon strain and achilles tendinitis.
4. If the running distance increases too fast and you train too much, it will bring greater impact to Achilles tendon. When doing physical exercise, we must step by step and slowly increase the amount.
5. Too hard running ground and running shoes may cause Achilles tendon inflammation. Adding a pad to the heel helps to relieve the tension of the achilles tendon.