ACHILLES TENDONITIS
If you suffer from pain and have a tender swelling in the large tendon (Achilles tendon) which attaches on the back of your heel bone, (calcaneus), you most likely are suffering from Achilles tendinitis. The pain is generally worse in the morning or after you have done some exercise.
What causes Achilles tendonitis? The Achilles tendon is a thick band of collagen which attaches your calf muscles to your heel bone. These muscles cause your foot to point downwards and to propel you forward when you are walking or running. When you are walking, your foot at first pronates (the sole turns outwards) and the bones of your midfoot separate to accommodate to the irregularities of the ground (they become a loose bag of bones). As your leg moves forward your foot supinates, that is, the sole of your foot tends to turn inward. This causes the bones of your midfoot to lock together so that your foot becomes a rigid lever that your calf muscles can use to easily propel you forward. If your foot is overpronated, your foot will not supinate when your leg moves forward which means that your calf muscle, instead of having a rigid lever to work with has to strain to pull up your midfoot which is only a loose bag of bones at that point. This will overstrain not only your calf muscles but also your Achilles tendon. If you're a heavy, older, do a lot of jumping or running or prolonged walking, you are more likely to injure your Achilles tendon. When this happens, the tendon will develop many small tears and your body will try to fix them with inflammation. This is what will cause the swelling and tenderness which you find in Achilles tendonitis.
How do you treat Achilles tendonitis? If you're starting to feel pain in your Achilles tendon, the first thing to do is to reduce the strain on the tendon. Lose weight, rest, wear heel lifts in your shoes underneath your heels. This will reduce the distance your heel has to travel when you're walking or running. Wear orthotics which, in addition to providing a heel lift, will support your medial arch and prevent your foot from pronating. Do stretching exercises to increase the elasticity of your Achilles tendon. One of the best exercises you can do is called eccentric loading exercises, which a physiotherapist can teach you. A study has shown that doing eccentric loading exercises together with prolotherapy was the most effective way to treat Achilles tendinitis.
M J Yelland, K R sweening, J A Lyftogt et.al Prolotherapy injections and eccentric loading exercises for painful Achilles tendoinosis: a randomized trialBr. J. Sports Med. Published online June 22, 2009
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