Do You Have Achilles Tendinitis?

Do you have pain at the back of your foot, just above the heel?  It could be Achilles Tendinitis.  Achilles Tendon

The Achilles tendon is the largest tendon in the human body. It is located at the back of the ankle joint and attaches the calf muscles to the heel bone. This tendon is used to walk, run, jump and push up on the toes. Achilles tendinitis is the inflammation of the tendon and is most often caused by overuse, or is a result of a strain injury.

SOME CAUSES

According to orthopedic foot and ankle surgeon, Dr. Mark Yakavonis, aging and sports activities that involve a lot of calf muscle usage, like basketball and tennis, have a higher incidence of injury to the Achilles tendon. Achilles tendinitis is also associated with a sudden increase of intensity or frequency of an exercise.

“People with Achilles tendinitis usually feel a dull ache or pain during activity and they may feel tenderness above the heel bone, particularly in the morning,” Dr. Yakavonis said. Stiffness that improves as the tendon warms up and mild swelling or a bump are other possible symptoms. However, sudden pain, swelling above the heel, difficulty walking or moving the foot up or down may indicate a rupture of the tendon. “Whenever there’s pain in that tendon area, it’s a good idea to have an orthopedic foot and ankle specialist take a look at it to determine if it is due to tendinitis or a more serious condition such as a partial tendon tear, heel bursitis or a rupture,” he said.

TREATMENT

When treated properly, Achilles tendinitis is usually resolved quickly. When left untreated, it may lead to a more serious condition or tear.

Some or all of the following may be used to treat the condition depending on its severity:

  • Rest

  • Nonsteroidal anti-inflammatory medication

  • Orthotics or shoe inserts that help support the muscle and relieve stress on the tendon

  • Bracing to restrict motion

  • Physical therapy that includes stretching, massage, ultrasound and strengthening exercises

  • A home exercise program

SURGICAL TREATMENT

Surgical treatments vary depending on the type of Achilles tendinitis a patient has and the severity of it. Some minimally invasive surgical treatments, addressing the calf muscle or heel bone, are new and exciting. If friction between the tendon and its covering sheath causes the sheath to become thick and fibrous and conservative treatments are not effective, surgery may be an option. A surgeon can remove the fibrous tissue and repair any tears. In some cases, where there is severe damage, the Achilles is reconstructed using an adjacent tendon. A temporary cast may be worn during recovery and a rehabilitation program is usually recommended.

PREVENTION

Dr. Yakavonis recommends the following tips to prevent Achilles tendinitis:

  • Choose a running shoe that provides cushion to the heel.

  • Walk and stretch to warm up gradually before exercising.

  • Stretch and strengthen the muscles in the calf.

  • Increase running distance and speed gradually.

  • Avoid unaccustomed strenuous sprinting and hill running.

  • Cool down gradually after exercise.

Can high heel boots be dangerous?

Trendy high heeled boots may be the height of winter fashion, but they are a disaster waiting to happen for women wearing them, according to orthopedic surgeon, Mark Yakavonis, MD, MMS, a foot and ankle specialist with Orthopaedic & Neurosurgery Specialists (ONS) in Greenwich and Stamford, CT.High Heeled boots for web 3

“Any high heel worn with regularity can damage the structure of the foot and weaken the ankle. High heeled boots do the same kind of damage and they don’t provide adequate stability on snowy and icy surfaces,” he said.

Now that temperatures are dipping below freezing, icy patches on sidewalks and steps are presenting a serious threat to firm footing. According to the American College of Foot and Ankle Surgeons, slips and falls from high heeled boots account for hundreds of injuries each year, including sprained and broken ankles, toes and metatarsal bones. Elsewhere in the body, falls from spiky boots commonly result in broken wrists as well as strains in the leg, back and neck muscles.

Infographic_HighHeelsEven on dry land, the physical hazards of wearing high heels are well known. Beyond pinched toes, blisters and aching arches, Dr. Yakavonis noted wearing heels over a prolonged period of time can damage muscles, tendons and nerves in the feet. Wearing heels also seem to play a role in the development and worsening of bunions and they wreak havoc on balance and posture. A recent study conducted by researchers at Hanseo University in South Korea followed a group of young women training to become airline stewardesses who were required to wear high heels throughout their four year program. When compared to incoming freshmen, the ankle muscles of women who were seniors were misaligned and considerably weaker, Additionally, the senior women had dramatically worse balance.

Foul winter weather makes wearing heels all the more precarious. Dr. Yakavonis warned, “All it takes is one misstep to end up with a serious injury, lost time from work and possibly even surgery.”

If you do hurt yourself falling off those stylish heels, advised Dr. Yakavonis, immediately use the RICE method – rest, ice, compression and elevation – to help reduce the pain and swelling. Even if you can walk on the injured foot, seek a medical evaluation if there is swelling and bruising as those symptoms can indicate a serious injury, Left untreated, injuries can result in long term complications such as chronic ankle instability, pain, arthritis and deformity.

A safer bet, however, is to opt for more appropriate foul weather boots with a wide heel, no higher than an inch, and a treaded heel and sole. They may not be the most fashionable accessory, but then again, a cast and crutches aren’t either.

07/10/2019