Many heel and ankle problems are associated with the Achilles tendon. Achilles tendon bursitis is one such problem, and it can literally be a pain in the heel.
Anatomy Of The Achilles Tendon And Bursae
The Achilles tendon, also called the calcaneal tendon or heel cord, is a long and very strong rope-like structure. It can be felt between the back of the lower leg and heel. It attaches the calf muscles to the calcaneus heel bone. When the muscles in the calf contract, they pull the Achilles tendon, thereby pulling the heel. This mechanism is what enables humans to rise to their toes and is vital to jumping, running, and walking activities.
Bursae are fluid-filled sacs that act as cushions between certain moving tissues in the body. There are deep and superficial bursae most everywhere that a tendon, ligament, muscle, or the skin rubs across a bone. Bursae prevent friction and abnormal wear and tear from occurring as these soft tissues rub across the substantially harder bone. Bursae produce a protein and collagen rich fluid that lubricates the area and further reduces friction.
The human body has the unique ability to create a bursa wherever needed. So, the number of bursae can vary from person to person. That said, there are two main bursae located near the Achilles tendon. The anterior bursa is called the retrocalcaneal bursa. It’s located between the heel bone and Achilles tendon. There’s also a superficial bursa, called the subcutaneous calcaneal bursa or Achilles bursa. It’s located between the surface of the skin and the posterior distal aspect of the Achilles tendon.
What Is Achilles Tendon Bursitis?
Inflammation of either or both of these bursae is called Achilles tendon bursitis. When the bursae become irritated from overuse or repetitive use or suffer a direct injury, the bursa can become inflamed and produce extra fluid. Bursitis may also be caused secondary to certain infections, such as Staphylococcus; gout or pseudogout, or rheumatoid arthritis. Remember that there are two main bursae near the Achilles tendon. Bursitis affecting the anterior Achilles tendon is sometimes referred to as retrocalcaneal bursitis and Albert’s disease. Bursitis affecting the posterior Achilles tendon is sometimes referred to as Haglund's deformity.
What Causes Achilles Tendon Bursitis?
Bursitis of the bursae near the Achilles tendon is usually the result of an injury, disease process, overuse or repetitive use, or degenerative process affecting the Achilles tendon. Achilles tendon bursitis is often associated with prolonged walking, especially in high-heeled shoes or shoes that fit poorly; excessive or prolonged exercise; abnormal pronation of the foot; and certain sports that place a strain on the Achilles tendon with jumping activities, running, or frequent starts-and-stops, such as ballet, gymnastics, football, soccer, hockey, and such. Shoes that place pressure on the back of the heel or push the heel into the back of a shoe can especially irritate the superficial bursa.
What Are The Symptoms Of Achilles Bursitis?
* pain at the back of the heel that may increase with up and down foot movements
* a possible slip or pop may be felt during walking as structures don't glide as smoothly over the inflamed bursa
* swelling, tenderness, redness and heat over the affected portion of the Achilles tendon
* a localized lump may occasionally be felt
* certain shoes that place pressure or rub across the Achilles tendon may be very painful, if not impossible, to wear
Strengthening Exercises
These Achilles Tendon Bursitis Exercises are ideal to build strength and flexibility.
Massage Treatment
These Achilles Tendon Bursitis Massage Techniques are of great value in pain relief; circulation stimulation; dispersing blood and fluid accumulations; swelling reduction; and relaxing muscle spasms, especially when used alongside the Sinew Therapeutics liniments and soaks.
ACUTE STAGE SYMPTOMS AND TREATMENT
This stage is characterized by swelling, redness, pain, and possibly a local sensation of heat, indicating inflammation. If coolness makes your pain feel better, then the Acute Stage Treatment is recommended.
ACUTE STAGE SYMPTOMS:
The acute stage starts the moment an injury occurs and lasts until the swelling and inflammation are gone. The swelling is the result of the blockage of blood, tissue fluids and circulation in the Achilles tendon because their normal movement has been disrupted by the force of the injury. Just like cars back up behind a traffic jam, causing congestion, exhaust and overheating; blood and fluids back up behind the injured Achilles tendon, causing pain, inflammation, lumps and swelling.
The sensation of heat is due to the warming action of the blood and fluids overheating in the injured Achilles tendon as they back up and accumulate. Stiffness and decreased mobility are due to spasms in tendons and ligaments that have contracted reflexively beyond their normal range from the impact of the injury.
As ligaments and tendons stretch and tear, blood from ruptured blood vessels becomes trapped in the local tissues. As the trapped blood clots up, it sticks the tissues together creating adhesions. Adhesions cause pain, inflammation and restricted movement because the layers of tissue that used to slide smoothly across one another now adhere and snap which interferes with normal functioning. It is essential to break up clotted blood as quickly as possible to prevent adhesions and scar tissue from forming.
During the acute stage it is very important to restore normal circulation to the Achilles tendon, break up clotted blood and stagnant fluids, reduce swelling, and reduce the redness and heat associated with inflammation. By restoring the flow of blood, fluids, and circulation in the Achilles tendon, then pain is relieved, damaged tissues can regenerate with healthy functional tissue, and the foot can strengthen and regain it's mobility.
ACUTE STAGE TREATMENT:
1. Apply the Sinew Herbal Ice on your Achilles tendon to reduce redness, swelling, and inflammation while dispersing accumulated blood and fluids to help restore normal circulation to the Achilles tendon. This first-aid treatment is used in place of ice to significantly speed up the healing process. It reduces the swelling and inflammation more effectively than ice, allowing you to more quickly regain range of motion. Acute Sinew Liniment can be used in-between applications.
Ice is not recommended because it does not help repair damaged tissues and keeps everything in the injured area frozen, causing the stagnation of blood and fluids and the contraction of muscles, tendons and ligaments. In Chinese sports medicine ice is not used and is considered a culprit in injuries that don't heal well.
2. Massage your Achilles tendon with Acute Sinew Liniment to relieve pain, reduce swelling and inflammation, break up clotted blood and stagnant fluids, and stimulate circulation of blood and fluids to help cells quickly repair damaged tissues. Sinew Herbal Ice can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
CHRONIC STAGE SYMPTOMS AND TREATMENT
This stage begins once the swelling and inflammation are gone, but you still feel pain, stiffness, weakness, and/or sensitivity in cold and damp weather. If heat makes your pain feel better, then the Chronic Stage Treatment is recommended.
CHRONIC STAGE SYMPTOMS:
The chronic stage begins once the swelling and inflammation are gone, but you still feel aching pain and stiffness. This is because there are still accumulations of stagnant blood and fluids in your Achilles tendon that are blocking circulation and blood supply to damaged tissues, creating residual pain, stiffness and weakness. You may actually feel hard nodules like sand in the tissue, indicating accumulation, calcification, and adhesions, which all cause pain, stiffness, and joint instability.
Your Achilles tendon may feel more sensitive to the cold and ache in cold and damp weather due to impaired circulation. When you move your foot you may hear a clicking or popping sound from the tendons and ligaments slipping very slightly in and out of their natural alignment indicating weakness and joint instability, causing chronic pain and a cycle of reinjury. These symptoms are often the result of failure to treat the injury properly from the outset and overicing.
Increasing circulation and blood supply to the damaged tissues is very important in treating chronic injuries because tendons and ligaments do not have an extensive direct supply of blood. That is why chronic injuries can be slow to heal. Increasing local circulation also prevents cold and dampness from penetrating the injured area, preventing pain and stiffness.
During the chronic stage it is very important to break up remaining accumulations of blood and fluids, and increase circulation and blood supply to the damaged tissues. By increasing circulation and blood flow in the Achilles tendon, then pain and stiffness is relieved, and the tendons and ligaments can strengthen to restore stability.
CHRONIC STAGE TREATMENT:
1. Massage your Achilles tendon with Chronic Sinew Liniment to relieve pain and stiffness, strongly stimulate circulation and blood flow to damaged tissues, and promote the healing of overstretched tendons and ligaments. The Sinew Relaxing Soak can be used in-between applications.
2. Soak your foot with the Sinew Relaxing Soak to relax muscles and tendons that are in spasm, ease joint pain and stiffness, and improve range of motion. The Sinew Relaxing Soak is particularly useful if you feel restricted mobility in your Achilles tendon. Chronic Sinew Liniment can be used in-between applications.
3. The Sinew Sports Massage Oil is recommended for use before and after exercise, sports and strenuous activity. It warms and stimulates your muscles, increases circulation and relieves tightness, hence improving your performance and helping to prevent injury.
