Tendinitis is an injury to the tendons, the strong bands of connective tissue that connect muscles to bones. The condition occurs when the tendon becomes irritated or inflamed and swollen, rubbing against the protective sheath that surrounds the tendons and supports them as they move. Achilles tendinitis is the most common type of tendinitis in the foot and ankle, involving the thick, strong tendon that connects the heel to the back of the calf muscle in the lower leg. Achilles tendinitis causes pain in and around the heel and radiating pain and discomfort that can extend into the calf area and through the foot. Symptoms typically become worse when running or performing other exercises or movements that require pushing off from the foot or exerting force on the bottom of the foot.
Achilles tendinitis most commonly occurs in people whose tendons are stiffer or even shorter than normal, resulting in an increased risk of irritation and injury. Repetitive activities like running, jumping, dancing and other activities that cause considerable stress on the tendons also increase the likelihood of Achilles tendinitis. Some arch problems can also elevate the risks of developing Achilles tendinitis, including “flat feet” that can cause the foot to roll outward when walking, straining the tendon. Certain types of footwear, an inherited foot shape or gait mechanics can also contribute to Achilles tendinitis, as can an increase in some types of physical activity, especially in people who have been inactive and sedentary. Achilles tendinitis is especially common among long-distance runners and among athletes who do not perform “warm-up” exercises prior to activity or who increase their activity level too quickly. And it’s also more common among older people whose tendons tend to be less flexible, making the tissues more prone to tiny tears and inflammation.
Mild to moderate tendinitis may be treated with rest, ice and medications to reduce pain and inflammation, combined with gentle stretching exercises and physical activity to promote strength, flexibility, and circulation for better healing. Custom orthotics can also be very helpful in providing necessary support and stability to the foot and the ankle. In very severe cases, surgery may be needed to repair the damaged tendon.
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