Achilles tendonitis is inflammation of the Achilles tendon. The Achilles tendon, also called the heel cord, is the large band of tissue extending the back of the ankle. It’s used each and every time a person walks, jumps, runs, or pushes up on their toes and is the strongest and thickest tendon in the human body. The main function of this tendon is to conduct the power of the calf to the foot. So, it shouldn’t be surprising that Achilles tendonitis accounts for around 11% of all running injuries.
Achilles Tendon Anatomy
The two calf muscles, the gastrocnemius and the soleus, descend downward to the most distal portion of the leg. It’s here where the Achilles tendon is formed and further extends downward to attach to the back of the heel (calcaneus.) When the calf muscles contract and pull the Achilles tendon, the foot is pushed downward to push off for motion. The tendon must be strong and thick because it’s subject to the entire weight of the body as each step is made. One interesting anatomy point related to Achilles tendonitis is that most tendons have a tendon sheath to bath the tendon in synovial fluid and nutrition. The Achilles tendon doesn’t have a true tendon sheath; it has a peritenon, or thin layer of fibrous tissue. While the absence of a true tendon sheath allows for a greater range of motion, it also limit’s the amount of nutrient rich circulation supplied to the tendon.
Achilles Tendonitis
Achilles tendonitis can be classified by location (about 4 cm above the heel in the middle of the tendon or at an attachment point) and as either acute or chronic (rapid or gradual onset.)
Acute Achilles Tendonitis
This is often from an injury or strenuous. The pain is usually moderate and appears about 2 to 3 cm from the tendon insertion point on the back of the heel during the start of an activity. The pain decreases in intensity as the activity progresses, but may regain intensity if the tendon is excessively used. A good example is a runner that experiences sharp Achilles tendon pain at the start of a run, has the pain subside toward the middle of the run, and then re-intensify toward the end of the run.
Symptoms Of Acute Achilles Tendonitis
* Pain that onsets over a few days
* Tenderness to touch
* Pain that occurs at the start of an exercise, subsides, and then reemerges
* Pain that subsides with rest
Chronic Achilles Tendonitis
Chronic Achilles tendonitis can cause the same type of pain as acute Achilles tendonitis. However, the pain location is generally at the insertion of the Achilles tendon into the heel. There may also be hypertrophy or enlargement of the Achilles tendon and posterior heel, a condition known as increased Phillip-Fowler angle. Chronic Achilles tendonitis doesn’t improve upon duration of use. The more it’s used, the more it will hurt. It may also follow untreated acute tendonitis.
Symptoms Of Chronic Achilles Tendonitis
* Pain that onsets gradually over weeks or months
* Constant pain throughout any exercise
* Pain when walking up stairs or inclines
* Pain and stiffness even after resting
* Tender to touch
* Possible lumps in the Achilles tendon
* Thickening or swelling of the Achilles tendon
* A crackling/creaking sound when the tendon is moved or touched
* Decreased strength and/or flexibility in the ankle
Causes Of Achilles Tendonitis
A traumatic injury is occasionally the causative factor, but overuse and repetitive or intense strain are the primary causes of Achilles tendonitis. Some examples of such would include:
* A drastic and speedy increase in one’s normal physical activity level
* Footwear or walking surfaces changes
* Weak or tight calf muscles
* A decrease in the range of motion in the ankle joint.
* Long distant incline running
* Overpronation
* Sports that require intense exercise or jumping, sudden starts and stops, or running on uneven or inclined surfaces
* Traumatic injury to the tendon
Strengthening Exercises
These Achilles Tendonitis Exercises are ideal to build strength and flexibility.
Massage Treatment
These Achilles Tendonitis 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.
