Achilles tendinitis is when the Achilles tendon, found behind the ankle, becomes irritated. The most common symptoms are pain and swelling around the affected tendon. Pain is usually worse at the beginning of the workout and decreases thereafter. Ankle rigidity can also be present. Onset is generally gradual.
This usually occurs as a result of excessive use such as running. Other risk factors include trauma, a lifestyle that includes little exercise, high heels, rheumatoid arthritis, and medications from fluoroquinolone or steroid classes. Diagnosis is generally based on symptoms and examination.
While stretching and exercising to strengthen the calves are often recommended for prevention, evidence to support this action is bad. Treatment usually involves rest, ice, nonsteroidal anti-inflammatory agents (NSAIDs), and physical therapy. Lift heels or orthotics can also help. In those whose symptoms persist for more than six months despite other treatments, surgery may be considered. Achilles tendinitis is relatively common.
Video Achilles tendinitis
Signs and symptoms
Symptoms can vary from pain or pain and swelling to the local area of ​​the ankle, or arson that surrounds the entire joint. With this condition, the pain is usually worse during and after the activity, and the tendons and joint regions may become stiff the next day as swelling that affects tendon movement. Many patients report stressful situations in their lives in correlation with the initial pain that may contribute to the symptoms.
Maps Achilles tendinitis
Cause
Achilles tendinitis is a common injury, especially in sports involving lunging and jumping. It is also a side effect of fluoroquinolone antibiotics such as ciprofloxacin, as are other types of tendinitis.
Swelling in the area of ​​micro-damage or partial tear can be detected visually or by touch. Increased water content and unorganized collagen matrices in tendon lesions can be detected by ultrasonography or magnetic resonance imaging.
Achilles tendinitis is thought to have physiological, mechanical, or extrinsic causes (ie footwear or training). Physiologically, the Achilles tendon is subject to a poor blood supply through the surrounding synovial casing. This lack of blood supply can lead to degradation of collagen fibers and inflammation. The tightness in the calf muscle is also known to be involved in the onset of Achilles tendinitis.
During the loading phase of the walking and walking cycle, the ankle and foot naturally pronate and supine about 5 degrees. Excessive pronation of the foot (more than 5 degrees) in the subtalar joint is a type of mechanical mechanism that can cause tendinitis.
Excessive injuries refer to recurrent stress and tension, which may occur in a resistance runner. Excessive use can mean increased intensity of running, jumping or plyometric training too quickly. Another consideration is the use of improper or worn footwear, which lacks the support necessary to maintain the foot in natural/normal pronation.
Pathophysiology
The Achilles tendon is an extension of the calf muscles and attaches to the heel bone. This causes the legs to grow (plantar flexion) when the muscles contract.
The Achilles tendon has no blood supply or good cell activity, so this injury can be slow to cure. Tendons receive nutrients from the tendon or paratendon sheath. When an injury occurs in the tendon, cells from surrounding structures migrate to the tendon to assist in repair. Some of these cells come from blood vessels that enter the tendon to provide direct blood flow to improve healing. With blood vessels coming nerve fibers. Researchers including Alfredson and his team in Sweden believe these nerve fibers are the cause of pain - they inject local anesthesia around the vessels and this significantly reduces the pain of the Achilles tendon.
Diagnosis
Achilles tendinitis is usually diagnosed from a medical history, and a physical examination of the tendon. The proximional radiograph shows calcified deposits in the tendon in the calcaneal insertion in about 60 percent of cases. Magnetic resonance imaging (MRI) can determine tendon degeneration rates, and may indicate differential diagnoses such as bursitis.
Prevention
Doing consistent physical activity will increase the elasticity and strength of the tendon, which will help in the fight against applied forces.
When stretching before starting an exercise session is often recommended evidence to support this practice is bad. Prevention of recurrence includes following appropriate sports habits and wearing low heels. In cases of alignment of the wrong foot, orthotics can be used to position the foot correctly. Footwear devoted to providing shocks can be used to maintain tendon length. Achilles tendon kick can be a result of exceeding the ability of the tendon to load, therefore it is important to gradually adapt to the exercise if someone is inexperienced, inactive, or an athlete who is not developing at a stable level.
The eccentric strengthening exercises of the gastrocnemius and soleus muscles are used to increase tendon tensile strength and extend the muscle-tendon joint, reducing the amount of tension experienced by ankle joint movement. This eccentric training method is very important for individuals with chronic Achilles tendinosis that is classified as collagen fiber degeneration. It involves repetition slowly raising and lowering the body while standing on the affected leg, using opposite arm to help balance and support if needed, and starting with the heel in the hyperextension position. (Hyperextension is usually achieved by balancing the front foot at the edge of the step, the thick book, or the weight of the barbell so the heel's point is a few inches below the front foot.)
Treatment
Treatment usually involves rest, ice, nonsteroidal anti-inflammatory agents (NSAIDs), and physical therapy. Lift heels or orthotics can also help.
- Eccentric exercise routines designed to strengthen the tendon.
- Application boot or transmission.
Injection
Evidence to support poor injection therapy.
- This includes corticosteroid injections. This can also increase the risk of tendon rupture.
- Autologous blood injections - the results have not been very encouraging and there is little evidence for their use.
Procedures
Temporary evidence supports the use of extracorporeal shock therapy.
Epidemiology
The prevalence of Achilles tendinitis varies among different age groups and people. Achilles tendinitis is most commonly found in individuals aged 30-40 vulnerable Runners, as well as anyone participating in sports, and men aged 30-39.
Risk factors include participating in sports or activities that involve running, jumping, running, and speed changes. Although Achilles tendinitis is most likely to occur in runners, it is also more likely in participants in basketball, volleyball, dancing, gymnastics and other athletic activities. Other risk factors include gender, age, improper stretching, and overuse. Another risk factor is any congenital condition in which an individual's legs rotate abnormally, which in turn causes the lower extremity to stretch and contract; this puts stress on the Achilles tendon and will eventually cause Achilles tendinitis.
References
External links
Source of the article : Wikipedia
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