What Is Insertional Achilles Tendonitis?
The Achilles tendon is a band-shaped tendon fiber that connects the muscles of the back of the calf and the calcaneus. Tension is transmitted to the Achilles tendon through muscle contraction. Because the cross section of the Achilles tendon is much smaller than the muscle tissue, about 1:60, the unit tension of the Achilles tendon tissue is much higher than the muscle. Achilles tendinitis generally refers to the aseptic inflammation formed after the acute and chronic strain of the Achilles tendon. During exercise, the calf gastrocnemius and Achilles tendon are subjected to repeated excessive tension. In addition, suddenly increasing the intensity or frequency of exercise can often cause Achilles tendinitis.
Basic Information
- English name
- achilles tendinitis
- Visiting department
- orthopedics
- Multiple groups
- Running and jumping hobbyists
- Common locations
- Achilles tendon
- Common causes
- Related to unadjusted before exercise, excessive exercise, trauma, etc.
- Common symptoms
- Pain, soreness, tenderness, stiffness above and inside the heel, exacerbated after exercise
Causes of Achilles Tendonitis
- When the Achilles tendon is stressed for a short period of time, strain, minor bruises or tears may occur, and aseptic inflammation may occur.
- Other causes of Achilles tendinitis:
- Adjustment before exercise
- Starting to exercise without physical activity or adjustment, such as basketball, tennis and other sports that need to be stopped, started and jumped frequently, Achilles tendinitis is prone to occur.
- 2. Excessive exercise
- 3. Flat feet
- A flat arch increases the risk of Achilles tendinitis. When walking, flat feet can cause additional stress on the Achilles tendon.
- 4. Trauma or infection
- Trauma or infection near the Achilles tendon.
Clinical manifestations of Achilles tendinitis
- The Achilles tendon does not have a tendon sheath in the true sense, but is surrounded by the tissue around the tendon (fatty interstitial tissue to separate the tendon and tendon sheath). The early pain of Achilles tendonitis is mainly caused by the damage of the tissue around the tendon. When walking, tendon activity in the tissue around the tendon increases, so the pain is aggravated, and the pain will also increase during training. Pressing the Achilles tendon with your fingers has tenderness.
- Typical symptoms: above the heel, internal pain, soreness, tenderness, stiffness, exacerbation after exercise. It can occur in any area of the Achilles tendon, and the pain usually occurs in the early morning or during rest after strenuous exercise. There is intense pain or tenderness when the two tendons are squeezed. When the lesion worsens, the tendon will swell and nodules will appear in the lesion area.
- Acute phase
- Pain, swelling, and redness of the skin at the Achilles tendon during walking and running.
- Chronic phase
- Achilles tendon pain or stiffness, often in the early morning. Walking, especially climbing and going upstairs, can cause pain in the Achilles tendon; chronic Achilles tendinitis is long and persistent.
Achilles tendinitis diagnosis
- 1. Ask patients about their daily activities.
- 2. To check the feet, an X-ray examination of the Achilles tendon area is required to rule out other diseases that may cause pain in the Achilles tendon.
- 3. Magnetic resonance (MRI) scan, which uses magnetic fields to display images of the body's soft tissues and diagnoses whether the Achilles tendon is broken or not.
Achilles tendinitis complications
- Achilles tendinitis can progress to a degenerative disease called Achilles tendon degeneration, which means that the structure of the Achilles tendon becomes abnormal, becoming more fragile and fibrotic. In addition, persistent strain or acute trauma to the Achilles tendon can cause the Achilles tendon to rupture and require surgery to repair it.
Achilles tendinitis treatment
- Self-help method
- (1) Warm up before exercise, stop it gradually, and do appropriate relaxation activities after exercise.
- (2) Pay attention to rest, avoid weight bearing, and exercise reasonably.
- (3) Wear suitable shoes when exercising. Choose shoes that fit the frequency of the exercise, the floor of the exercise, and the conditions of the exercise.
- (4) Frequently pull and strengthen calf muscle training, and gradually increase mountain climbing and stair climbing projects in daily sports. If necessary, increase speed and distance gradually.
- 2. Use a support pad
- The support pad can raise the ankle to reduce stretching of the Achilles tendon. Splints can also be used during nighttime sleep to keep the Achilles tendon fixed. If the condition is serious, it is recommended to wear walking boots or use a crutch to facilitate Achilles tendon repair.
- 3. Surgical treatment
- Non-surgical treatment (including physical therapy) can make Achilles tendinitis heal and self-repair within a few weeks. If the treatment is not effective, surgery is needed to remove the inflammatory tissue around the Achilles tendon.
- 4. Topical medication
- Use topical anti-inflammatory and analgesic drugs.