Suffering From Achilles Tendinitis Does NOT Have to Spell the End of the Season for an Athlete!

Suffering From Achilles Tendinitis Does NOT Have to Spell the End of the Season for an Athlete!

Suffering Achilles tendinitis does not have to mean the end of the season for an athlete. It is a very painful and debilitating injury with serious consequences but in many cases with the right help and advice athletes can be back training in no time.

Achilles Tendinitis - Prevention and Treatment provides essential information on how you can prevent this condition from wrecking any athletes training and utterly destroying their performance results

"This is fantastic", you are most likely thinking, "but what about the pain"?

You are right! It's not always a case of recovery and rehabilitation - you need to consider managing the pain.

For the majority of athletes, pain is something that they experience at one time or other during their sporting lives. Indeed if they play contact sports, some of them expect… perhaps even relish… a degree of pain.

Then there are the common locker-room expressions, "No pain, no gain" and "Pain is temporary, winning is forever", that somehow legitimise such discomfort. The subtext being: if you can't stand pain you must be a wimp.

But the temporary discomfort of a crunching tackle in rugby or football is one thing; the acute pain of Achilles Tendinitis is quite another - not to mention the chronic, nagging pain of a knee injury that simply won't go away.

Pain, whatever its cause, should always be taken seriously. On examination it could turn out to be nothing to worry about. But equally it could be an indicator of a career-threatening condition… and even, on occasion, life-threatening.

Achilles Tendinitis: Prevention and Treatment

The Three Steps to Recovery contained in Achilles Tendinitis - Prevention and Treatment work on the injured ankle in order to:

• Strengthen muscles involved in the injury to be just as strong as the unaffected side
• Regain full proprioception (joint position sense)
• Regain power and co-ordination of all sports specific movements

Achilles tendinitis - clinical facts

Achilles tendinitis is a loose term used to describe the pain, swelling, and tenderness usually experienced in the area 2cm to 6cm 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 'tendinitis' 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. Although surgery is sometimes used to correct this injury, Achilles Tendinitis - Prevention and Treatment raises important questions about the effectiveness of surgical procedure.

Assessing risk

The likelihood of injury increases with the number of years of running, the training pace and the weekly mileage. Achilles tendinitis is an overuse injury. The longer you have been running, the more likely you are to suffer and the condition is most commonly seen in male recreational runners between 35 and 45. As described below, the way we run can affect the Achilles tendon and this needs to be analysed.

How the way we run can cause injury

Running consists of a co-ordinated 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 co-ordinated joint movements has a weak link, then other parts of the chain have to compensate and excess stress can occur. An analysis of the running biomechanics of running shows exactly how, when and to what extent the muscles work during the phases of running and reveals how inefficient biomechanics can cause injury.

A Common Misunderstanding about Muscle Activity 

The nature of leg muscle activity when you start running at push-off is quite the opposite of what you might expect to happen. In fact, the muscles - quadriceps, gastrocnemius, soleus, anterior tibialis, gluteus maximus, and hip abductors - are not active during the push-off phase. They only become active just before foot-down to prepare the body for impact with the ground. The muscles act to provide a stiffness to the joints in order to control the landing. Only the hamstrings and adductors are active during the push-off phase. Contrary to what many believe about running muscles, the energy from the push comes from the tendons and not from active contractions of the muscles.

Rear Foot Pronation and Ankle Strength

Research found that, after looking at a whole host of factors, a greater degree of rear-foot pronation and reduced ankle-muscle strength were strongly associated with Achilles tendinitis. This means runners 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. You'll find these exercises described in Achilles Tendinitis - Prevention and Treatment.

The Causes of Achilles Tendinitis:

Research has indicated insufficient strength of the gastrocnemius, soleus and anterior tibialis, and specifically insufficient eccentric strength, will result in poor control of the dorsiflexion and pronation during the foot-down and cushioning phases of running. If these movements are not controlled, particularly the velocity of pronation, then this can cause an excessive whipping of the Achilles tendon as the foot strikes the ground and the knee rolls forward over the foot, which may result in injury.

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.

Functional exercises for the Achilles:

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. The exercises given in Achilles Tendinitis - Prevention and Treatment develop specific strength in the ankle muscles that are immediately related to Achilles tendinitis, and also the rest of the leg and the pelvis to promote a good and efficient running style.

The purpose of these functional exercises is to strengthen the leg muscles in a similar manner to the way they work during running and to target the eccentric strength of the gastrocnemius, soleus and anterior tibialis. Exercises given in Achilles Tendinitis - Prevention and Treatment include prevention and strengthening programmes for the leg and ankle:

• Ankle to toe walks
• Heel walks
• Heel drop and calf raise
• One-leg knee bends
• Dynamic one-leg knee bends
• Dynamic ankle joggin

Managing Pain in sports

Managing Pain in Sport covers several important topics that as a serious athlete you need to know about

Why the traditional focus on physical points of pain is out-dated

How some common anti- inflammatory treatments do more harm than good…

Revolutionary approaches to the diagnosis & treatment of chronic pain…

Why care professionals need to pay more attention to their 'bedside manner…and much more…

Here are just some of the fascinating facts we uncovered - and which you'll learn about exclusively in Managing Pain in Sport

• The Techniques athletes should use to distinguish between benign and potentially damaging pain - before having to consult a professional.
• How can some athletes manage to shrug off even a painful injury, and continue competing - while others are forced to drop out?
• Why it is someone can continue to feel pain even after the injured tissue has healed - or removed completely by surgery?
• How you can treat pain from almost anywhere in the body - and the implications of this fact for successful patient outcomes.
• How to spot the telltale signs of neurologically-produced pain - and how to distinguish it from acute pain associated with actual tissue damage.
• Why the clinician's 'bedside manner' has such a huge impact on how well patients copy with pain, and their recovery.
• How the 'biopsychosocial' approach to treatment differs from the more traditional 'biomedical' approach - and why it's so much more effective in most cases.
• How do the various menstrual phases affect athletic performance - and what lessons should be learned by coaches and athletes alike when setting their training and competition goals?
• Why the so-called 'graded approach' to rehabilitation can actually speed up recovery from pain and injury.
• How and why certain commonly-used pain relief medications can actually retard the recovery process - and cause potentially-serious problems in the longer term. The report is well worth reading for this chapter alone.
• How to fight inflammation naturally - including details of a common daily supplement that research shows is at least as effective in reducing pain as ibuprofen!
• And much, much more…

To know more about rehabilitation protocol injury treatment and prevention please write on 

padhye_omkar@rediffmail.com to Dr. Omkar P Padhye(mpt-mss).

References

1.Paul van der Linden et. Al. “Increased Risk of Achilles Tendon Rupture with Quinolone  Antibacterial Use” Arch Intern Med 2003;  163: 1801-1807.
2. Baer GS, Keene JS. “Tendon Injuries  of the Foot and Ankle: Achilles Tendon  Ruptures.” In Orthopedic Sports Medicine:  Principles and Practice. (Third Edition) Ed. DeLee and Drez, Saunders, Philadelphia,  PA, 2010 2002-2011.
3. Twaddle, Poon. “Early motion for Achilles  Tendon Ruptures: Is Surgery Important?”  AJSM 2007 2033-2038.
4. Nilsson-Helander et al. “ Acute Achilles  Tendon Rupture: A Randomized,  Controlled Study Comparing Surgical and  Nonsurgical Treatments Using Validated  Outcome Measures” AJSM 2010.

Dr.Omkar P Padhye

Mpth-mss

padhye_omkar@rediffmail.com