Achilles Tendinitis (Tendonitis)

The suffix "itis" refers to something that is inflamed, therefore, the term tendinitis (also spelled tendonitis) is used when a tendon is inflamed. There are 2 types of tendonitis that can occur in the Achilles tendon, acute and chronic. The term acute tendinitis refers to inflammation that comes on suddenly or within a few days, usually due to a tendon strain or overloading the tendon during exercise.

Chronic Achilles tendinitis occurs when the Achilles tendon becomes inflamed over a period of time, usually due to repetitive overuse or irritation. It may be a result of acute tendinitis that has been left untreated or has not been allowed sufficient rest.

If you feel a sharp pain, as though you've been hit in the back of the ankle, and hear a "pop" sound, your Achilles tendon has likely ruptured. A ruptured (completely torn) Achilles tendon is caused when the Achilles tendon is overstressed to the point of tearing. It will be very difficult for you to walk or move your ankle if this is the case.

Acute Tendinitis

In the case of acute Achilles tendonitis, most individuals can identify an injury or specific event that caused a strain or tearing of the Achilles tendon. When the fibers of a tendon are torn, they become inflamed and swollen causing pain and tenderness in the area which can also result in difficulty flexing the foot during regular movements, such as walking and jumping.

Most commonly, this condition is seen in the "weekend warrior" athlete who sits at a desk all week and then plays softball or tennis on the weekend. The resultant muscle strain (mild tears) creates inflammation and pain and can lead to tendinitis. This condition could also be created if the tendon is strained from a sudden trauma such as a fall or misstep.

Achilles tendinitis can occur at the insertion point of the tendon (referred to as insertional tendinitis) at the calcaneus (heel bone) or mid way up the Achilles tendon (referred to as non-insertional tendinitis). The most common area to be affected by acute tendinitis is approximately 1/3 of the way up the tendon, 2.5 inches from where it attaches to the heel bone. This part of the Achilles tendon is at most risk of tendinitis and other tendon injuries because it receives less blood flow than other parts of the tendon.

Symptoms of Acute Tendonitis

If you are suffering from acute Achilles tendinitis you will most likely be experiencing:

• Pain that occurs abruptly following a tendon strain, usually part way up the Achilles tendon.
• Sharp pain at the beginning of activity that decreases in intensity as exercise progresses.
• Pain that returns after exercise or after long periods of inactivity.
• Pain may subside when the Achilles tendon is allowed to rest.
• Pain becomes most significant when pushing off or jumping.
• Stiffness in your Achilles tendon when you wake up in the morning.
• Tender and warm to the touch.
• The Achilles tendon is irritated by heat but feels good when treated with cold compression and rest.

Causes of Acute Tendonitis

• Improper stretching before and after running and jumping exercises.
• Changes in foot wear (i.e. high heels, poor running shoes).
• An inflexible Achilles tendon (i.e. tendon with scar tissue from previous injury or wear and tear).
• An increase in training, training on uneven terrain or a change in terrain (i.e. hills) .
• Weak or inflexible calf muscles (gastrocnemius or soleus muscles).

Chronic Achilles Tendonitis

The pain of chronic Achilles tendonitis can occur lower down the ankle at the insertion point of the tendon (referred to as insertional tendinitis) into the heel bone or part way up the tendon (referred to non-insertional tendinitis). In addition, it is common that the tendon becomes enlarged and inflexible with the build up of scar tissue.

Although this condition is very common among male recreational runners between the ages of 35-45, Achilles tendinitis can also affect people participating in lower impact sports, like golf, and less active pastimes, such as gardening who may have poor foot mechanics or weakened muscles and tendon tissue.

Symptoms of Chronic Achilles Tendinitis

• A gradual onset of pain with no specific event known as the cause
• A thicker or swollen Achilles tendon
• Constant pain throughout exercise and even during daily activity
• A possible lump in the tendon approximately 2 inches above the heel
• Pain that increases when walking uphill or up stairs
• Pain and stiffness after long periods of rest
• Tender and warm to the touch
• Pain becomes most significant when pushing off or jumping
• A creaking feeling may occur when you press the tendon or move your ankle

Causes of Chronic Achilles Tendinitis

• Acute Achilles tendinitis that has gone untreated.
• Not warming up or stretching before and after exercise.
• Wearing high heels over a long period of time. High heels cause the calf muscles to contract providing less slack in the Achilles tendon.
• An inflexible Achilles tendon (i.e. tendon with scar tissue from previous injury or wear and tear or acute Achilles tendinitis).
• Training on uneven terrain or a change in terrain (i.e. hills) .
• Weak or inflexible calf muscles (gastrocnemius or soleus).

• Flat feet (also called pes planus or fallen arches) can cause extra stress on the Achilles tendon.
• Over-pronation of the foot (rolling your foot inward too much when you walk or run which may be due to having high arches).
• Bony growths around the heel (sometimes caused by arthritis) which irritate the Achilles tendon.

Chronic Achilles tendinitis can be a difficult condition to treat due to the build up of scar tissue on the tendon. Scar tissue causes pain and inflexibility and leaves the tendon prone to further injury. Fortunately, with use of the cold compression, therapeutic ultrasound, and Blood Flow Stimulation Therapy (BFST^®) you can treat your scar tissue and heal your tendon to restore its proper function.

Achilles Treatments - What You Can Do!

The trick with any tendon injury is getting it to heal with minimal scar tissue formation - something ultrasound therapy is great at! Even with optimum healing, there is always less elasticity in a previously injured tendon. However, if you heal your injury efficiently and quickly, your chance of re-injury later on is much lower than average.

Allowing your Achilles tendon to rest is always recommended following injury. Avoid all activities that may have caused the injury or irritation and begin cold compression treatments as soon as possible. The Achilles tendon is a difficult tendon to rest completely as it is an essential tendon for walking and daily activities. Fortunately, there are healing tools that can help treat your tendon and speed up the healing process so you can get back to a life without pain and risk of further injury. Therapeutic ultrasound and BFST^® will treat scar tissue and promote blood flow to heal your tendon faster and more completely than any other methods available.

Although steroid injections may provide temporary relief of the pain of Achilles tendinitis, they should generally be avoided as they weaken the tendon and may lead to a rupture of the tendon. If you do opt for an injection, doctors usually recommend that you do not participate in strenuous activities for several weeks to reduce the risk of a rupture.

Cold Compression Therapy

Doctors recommend using cold compression as soon as possible following an Achilles injury and re-injury to reduce pain and swelling and minimize tissue damage that occurs with soft tissue injuries like tendon tears.

The Ankle/Achilles Freezie Wrap^® allows you to treat your Achilles tendon in an effective and convenient way.

Cold Compression Therapy works by interrupting and slowing nerve and cell function in the injured area and reducing swelling that can block blood vessels. This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through the Achilles tendon and tissue cells begin to break-down. Without cold compression therapy cellular break-down and tissue damage continues as the cells do not get the oxygen they need to survive. By limiting the amount of damage done to your tendon, you also limit the amount of healing that needs to occur. This is a very important step to heal your tendon faster and with less pain!

The deep cooling effect provided by the Ankle/Achilles Freezie Wrap^® slows cell metabolism thereby reducing cellular break-down and tissue damage. Furthermore, because the cold wraps serve to numb the nerves, the wraps also reduce pain! Only the Freezie Wrap^® gel pack is charged in the fridge. This means the cooling temperature of the gel pack will not cause cold burns, or cryoburn, on your skin like ice or freezie charged gel packs can. You can also treat yourself for longer periods of time so you get lasting pain relief.

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Ultrasound Therapy

Ultrasound Therapy increases tissue elasticity while promoting the flow of blood (filled with vital oxygen and nutrients) to your injured Achilles tendon. This cleans the injured area by getting rid of damaged tissue and reducing the inflammation on the tendon while opening up the blood vessels to begin healing.

During the healing process, scar tissue builds on the tendon and can attach the inner layers of the tendon to the surrounding paratenon that it glides through, limiting the flexibility and movement of the tendon. Fortunately, you can treat your Achilles tendon with therapeutic ultrasound to soften scar tissue and improve the gliding motion and flexibility of your tendon.

Not only does ultrasound aid in the duration of healing, but it helps to prevent long term complications. Pain, lack of mobility, tendinosis, or a complete tendon rupture are some of the more common long term complications that can occur when Achilles injuries and tendinitis go untreated. By treating your tendon with ultrasound, scar tissue becomes softer and the tissue becomes stronger reducing the risk of chronic problems in the future.

For those who suffer from long term Achilles injuries, ultrasound can help. Ultrasound therapy can help to break up scar and fibrous tissue that has built up over time on the tendon and restore flexibility in your ankle.

MendMeShop^® ultrasound therapy is safe, convenient, and easy and generally requires between 5 - 10 minutes per treatment. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and slightly increase the temperature of your soft tissue cells. The waves are delivered through a hand held transducer and conductive gel that are used together in a slow, circular motion on your skin over the injured area.

Click here to learn more about Ultrasound Therapy

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

Using MendMeShop^® Lavender Infusion Ultrasound Gel during your therapy gives you 2 therapies in 1. You get the benefit of the regenerating sound waves from the ultrasound device itself AND the added bonus of the therapeutic ingredients inside the gel being delivered into the tissue where it is most effective. MendMeShop^® Lavender Infusion Ultrasound Gel comes with every MendMeShop^® Ultrasound Therapy System and it contains the therapeutic essential oils of natural Bulgarian lavender, peppermint, eucalyptus, and menthol.

Once the inflammation of chronic Achilles tendinitis has been reduced, nourishing and strengthening the tendon tissue and surrounding area is recommended. Using Blood Flow Stimulation Therapy^™ will speed your recovery and heal your tendon more completely preparing it for leg strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.

Blood Flow Stimulation Therapy^™

After the inflammation and swelling is gone you can begin to treat your Achilles tendon with Blood Flow Stimulation Therapy^™, or BFST^®. BFST^® increases the amount of blood that flows naturally to your ankle to nourish your tendons, ligaments and muscles to speed healing.

The Achilles tendon receives a limited blood supply compared to other tendons in the body and this greatly reduces its natural ability to heal itself.

By treating your Achilles tendon with Blood Flow Stimulation Therapy^™ you can increase your body's blood supply to the ankle and increase your body's natural healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from the injury leaving the area clean and able to heal faster. Our Ankle/Achilles Inferno Wrap^® provides effective, non-invasive, non-addictive pain relief and healing with no side effects.

Click here to learn more about how BFST^® works.

With these 3 easy therapies you will notice incredible improvement in your tendon. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results! During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your Achilles tendon until your pain and inflammation settle.

Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition.

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