2024-01-03 12:00:04
Every week, Dr Jean-Marc Sène, sports doctor, presents his sports column in Priorité Santé. This week he explains what Achilles tendinopathy, often called Achilles tendinitis, is and how to spot it.
Published on: 03/01/2024 – 11:00
3 mn
First of all, what is Achilles tendonitis? ? And how do we recognize it? ?
The Achilles tendon joins the calf muscles (the gastrocnemius and soleus) to the heel bone (the calcaneus). It is a very powerful tendon which is subjected to significant mechanical stress during walking and sporting activities.
Several types of injuries can affect the Achilles tendon. They are of very varied nature and affect different locations of the tendon (body of the tendon or its insertion on the bone for example). These lesions are more often due to micro-tears than to real inflammation, hence the grouping of these pathologies under the term Achilles tendinopathy. The common term tendinitis is therefore often inaccurate because it suggests that there is inflammation, which is not always the case.
Achilles tendinopathy is therefore characterized by pain in the heel or calf. The pain can be permanent or intermittent, appearing when warming up, disappearing with continued exercise and sometimes reappearing at the end of the exercise.
The doctor establishes his diagnosis by a clinical examination: he will be able to reproduce pain when palpating the tendon, when it is manually stretched or when you jump on the tip of your toes. He will also look for the presence of signs such as thickening or nodules. Your doctor may prescribe additional tests, for example an ultrasound or an MRI, to confirm his diagnosis.
How is Achilles tendinopathy treated? ?
At the first pain, it is recommended to stop any sports practice that puts strain on your tendon.
Your doctor will probably prescribe, depending on the type of tendinopathy, physiotherapy sessions with possibly massages, stretching or so-called eccentric bodybuilding exercises which are movements of controlled elongation of the muscles.
Physical treatments (shock waves, deep massages, etc.) or wearing a heel pad to reduce mechanical stress on the tendon can also relieve certain tendinopathies. If there is real inflammation, your doctor may advise you to take anti-inflammatory medications or apply cold. But be careful not to force too much while using an anti-inflammatory, because pain is a warning signal that should encourage you to adapt your activity!
Surgical treatment is a solution of last resort, considered when other treatments have been tried without success or for chronic cases where the risk of tendon rupture is major.
What causes Achilles tendinopathy to develop? ? How to avoid it ?
Physical overwork, such as practicing intensive sporting activities (running, dancing, etc.), is often the cause.
Other factors can promote the appearance of tendinopathy: aging, poor stability of the foot (cavus foot or flat foot), unsuitable footwear for the sport practiced, dehydration during intense physical effort or even taking medications such as certain antibiotics.
To avoid Achilles tendinopathy, remember to consult your doctor as soon as heel pain appears, especially if you are athletic!
Here are 5 tips:
1) Do not practice excessive training, also avoid bringing your competitions too close if you have them so as not to overwork your tendon.
2) After a period of stopping, gradually resume your sporting activity.
3) If necessary, correct the statics of your foot by wearing a suitable orthopedic insole.
4) Adopt sports hygiene rules during exercise, in particular by hydrating yourself properly.
5) Choose good training conditions. For example, be careful about the nature of the ground, which should be soft!
If you follow all of these tips you should be able to practice your favorite physical activity without tendon pain!
#case #Achilles #tendonitis