From the SAYSO Trainer’s Notebook
Achilles Tendonitis
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Achilles tendonitis
is a loose term used to describe the pain, swelling, and tenderness usually
experienced in the area 2 cm to 6 cm above the insertion of the tendon into the
heel bone. Around two thirds of Achilles tendon injuries in competitive athletes
are incidents of inflammation. When the term 'tendonitis' is used in a clinical
context, however, it refers to tendon degeneration without associated
inflammation. This may lead athletes and their coaches to underestimate the
chronic nature of the condition. Achilles
tendonitis is a painful and debilitating injury with sometimes serious
consequences. It can become so severe that many athletes undertake surgery to
correct the condition, particularly if the tendon has ruptured. Achilles tendonitis is an overuse injury. The likelihood of injury increases with the number of years of running, the training pace, and the weekly mileage. The older the player is, the more likely he/she is to suffer. The condition is most commonly seen in male recreational runners (i.e., weekend warriors) between 35 and 45. Achilles tendonitis is not a common injury among young soccer players. Running consists of a coordinated set of joint movements: foot down, cushioning phase, push-off and toe-off. The joints work together, cushion the impact and then propel the body forward. If this chain of coordinated joint movements has a weak link, then other parts of the chain have to compensate and excess stress can occur. A greater degree of rear-foot pronation (i.e., where the foot rolls inward a small amount, placing more weight along the outside edge of the foot) and reduced ankle-muscle strength has been associated with Achilles tendonitis. This means playing need to develop sufficient strength in the ankle muscles and use specific conditioning and running technique exercises to control excessive pronation of the rear foot. If these movements are not controlled, then they can cause an excessive whipping of the Achilles tendon as the foot strikes the ground and the knee rolls forward over the foot. The hip may also cause problems for the lower leg and Achilles tendon. This is an example of how the whole leg chain is dependent on all the links working correctly. If one area, such as the hip, does not perform its correct function, then other areas are adversely affected. Treatment consists of the usual elements for overuse injury. Rest the injury until it heels. Use ice and elevation. Take anti-inflammatories. Massage and physical therapy may also work. Subsequent pronation can be countered and prevented by orthotics, heel cups and wedges, and arch supports. Proper stretching prior to use is essential. The key to making a full recovery from any injury is not just corrective treatment and healing, but also re-strengthening and rejoining co-ordination of the joint and all the movements it is involved with. Some of the exercises that are recommended for this are: |