What Is Achilles Tendinopathy?
Achilles tendinopathy refers to pain due to the injury to the Achilles tendon, which is a structure that connects the calf muscle to the heel bone. It occurs due to the overuse of the Achilles tendon. Achilles tendonitis is common among athletes and sportsmen, especially in runners who involve in intense training involving the Achilles tendon for long durations. The stress during the activities leads to prolonged stress on the tendon leading to injury.
What Are the Causes of Achilles Tendinopathy?
The most common cause of Achilles tendinopathy is a repetitive strain on the tendon that occurs due during physical activity, exercise, and training. It is common among middle-aged who involve in sports activities. The strain on the tendon causes the transmission of force from the muscle to the heel bone leading to injury and pain. The causative factors for the condition are classified as follows:
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Intrinsic Factors: Body weight, age, gender, and height serve as etiological factors for the development of Achilles tendinopathy. All of these contribute to an increased extent of strain inflicted on the tendon.
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Extrinsic Factors: The extrinsic factors include poor training techniques and posture, altered training schedules, prior injuries, improper footwear, and training on surfaces that are too hard and too slippery, leading to excessive load on the tendon.
When repeatedly overloaded, tendons respond by inflaming their sheath and degenerating from the inside out.
What Are the Signs and Symptoms of Achilles Tendinopathy?
Pain localized in the heel region is the key symptom of this Achilles tendinopathy. It is often accompanied by tenderness and swelling in some cases. The mechanism of the development of the symptoms is not yet fully elucidated. However, the reason is attributed to the effect of mechanical and physiological changes occurring in the area due to the increased strain exerted on the tendon.
What Is the Role of Steroid Injections in the Treatment of Achilles Tendinopathy?
Chronic Achilles tendinopathy is a degenerative condition requiring close medical attention. It can lead to impaired performance in the athletes, often compromising their professional life. These cases are infrequently treated with steroid injections.
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Steroid injections include those medications belonging to the Corticosteroid class. They are anti-inflammatory medications. In general, Corticosteroids function by preventing the immune system from producing inflammatory responses. They do this by attaching to the body's glucocorticoid receptors. These medications create a complex when they bind to these receptors, which prevents the manufacture of inflammatory chemicals and has an anti-inflammatory effect.
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Corticosteroid injections also act by eliciting a local anesthetic (pain-relieving) effect. Hence, they aid in relieving the localized pain in the tendon region.
It should, however, be noted that Corticosteroid injections are only used as short-term therapies to treat inflammation and other symptoms. It has been reported to show greater efficiency when combined with physical therapy.
How Are Steroid Injections Administered in Achilles Tendinopathy?
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Corticosteroid shots will be administered by a healthcare professional. The provider will inject the shot at a site adjacent to the tendon. Improvements in symptoms will be experienced within four to six days after the shots are taken.
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A numbing medication will also be used and applied to the injection site.
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It is important to inform the doctor of any medical conditions, history of allergy, and the list of all the prescription and non-prescription medications the patient takes before the shot is administered.
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Avoid intense activity on the day that the shot is taken. If redness or swelling is experienced, apply an ice pack over the area for five to ten minutes.
What Are the Side Effects of Cortisone Shots for Achilles Tendinopathy?
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Corticosteroid shots can result in side effects like muscle weakness, fatigue, and weight gain.
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These medications also have the potential to increase the sugar levels in the body. Therefore, if symptoms like blurred vision, increased thirst, dry mouth, or extreme tiredness are experienced, contact the doctor immediately.
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The injections should be taken only as advised by the doctor. Avoid discontinuing the therapy abruptly. In case of any queries or concerns, contact the pharmacist or doctor immediately.
What Are the Other Management Options for Achilles Tendinopathy?
The other treatment options for Achilles tendinopathy include conservative treatment, physical therapies, medications, and devices, which are described below:
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Conservative Treatment: Immediate injury is often treated with RICE (Rest, Ice, Compression, and Elevation). This technique gives immediate relief to the pain and tenderness due to the injury.
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Medications: Pain-relieving agents like drugs belonging to the NSAID (Non-steroidal anti-inflammatory medications) are used to treat acute injuries. Chronic conditions require further medical intervention.
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Devices: Devices that provide physical support to the heel, like splints and braces, are often employed to aid in recovery and help with the symptoms.
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Physical Therapy: Physical therapies involving stretching and massages has shown to improve the condition.
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Surgery: Surgical interventions are considered when there is an inadequate response of the patient to other treatment options for over six months.
How to Prevent Achilles Tendinopathy?
Achilles tendinitis may not be preventable. However, there are steps to lower the risk. Some methods to decrease the risk in athletes are listed below:
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Progressive Increase of Physical Activity: An increased pace of training and exercise can overload the calf muscles. This can be prevented by gradually increasing the intensity and duration of such activities. For example, while starting an exercise regimen, start out lightly and build up the time and level of difficulty over time.
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Strength Training to Muscles: Includes exercises and training to become more muscular in the calves. The calf and Achilles tendon can better withstand the demands of exercise and activities when the calf muscles are strong.
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Cross-Training: Alternate low-impact exercises like cycling and swimming with high-impact ones like jogging and jumping can reduce the risk of injury.
Conclusion:
Although tendonitis of the Achilles tendon is frequently associated with sports, those who do not participate in sports often develop the condition. The tendon's severe overuse is the main contributing factor. If the issue is detected early, the majority of patients respond to conservative treatments. Steroid injections are often employed with therapy to treat chronic tendinopathy. Continuing the results of the activities result in chronic alterations that are more difficult to treat non-operatively.
