Excessive exercise over time can cause pain in the Achilles tendon over time. The Achillodynie results therefore from a continuous overload.

What is an Achillodynia?

Achillodynia describes the painful damage of the Achilles tendon, whereby the disease occurs almost exclusively in athletically active people and is one of the most common sports injuries.

Achillodynia describes the painful damage of the Achilles tendon, whereby the disease occurs almost exclusively in athletically active people and is one of the most common sports injuries.

The cause is usually a long-lasting over- or Fehlbelastung the Achilles tendon. The therapy is usually done with non-operative methods. If the damage is detected and treated early, disease progression can be prevented or at least stopped.

causes

The Achillodynie arises primarily by an over- or Fehlbelastung the Achilles tendon during sports. Not only professional athletes, but also recreational athletes can suffer, especially runners, football and tennis players, ballet dancers and triathletes. In particular, fast running or jumping movements lead to increasing wear of the Achilles tendon. Doctors refer to wear as a "degenerative change".

Mostly the lower part of the Achilles tendon on the heel is often affected, as the Achilles tendon is usually poorly perfused here, which heals injuries worse. Exposure to the Achilles tendon causes constant microtrauma (tiny damage). If the tendon is regularly overloaded, a mismatch arises between the numerous small microtraumas and the Achilles tendon can only regenerate to a limited extent.

How quickly achillodynia develops depends on several factors, such as the general physical state of exercise, type of exercise, duration, frequency, and intensity. Wrong footwear during sports or in everyday life can lead to incorrect loading of the foot, whereby the Achilles tendon is excessively stressed. Other possible causes include treatment with cortisone, as this can damage the connective tissue and thus the tendons, a higher age, overweight foot deformities such as a Senkfuß or metabolic diseases, such as increased uric acid and lipid levels in the blood.

Symptoms, complaints & signs

In most cases, an achillodynia develops slowly. First of all, sufferers in the Achilles tendon feel only a slight tweaking, which is especially the case in the morning after getting up, after prolonged breaks or the start of running training. At the beginning, however, this happens after some movement. Typical for the disease are stress-related pain, which occur in the lower leg and in the heel.

Also, a stiffness of the Achilles tendon in the morning can be an indication. In the further course, the symptoms in the Achilles tendon increase until they can finally occur at night or at rest. Those who ignore the initial pain and continue training may develop a lengthy achillodynia, which usually occurs during exercise. The Achilles tendon is swollen in this case, overheated and reddened.

Diagnosis & History

In the case of achillodynia, the diagnosis begins with the history (medical history). The doctor asks a few questions about the symptoms and sports behavior, for example, when pain persists in the Achilles tendon, if there are any known pre-injuries, when the pain is strongest, what kind of sports are practiced, how often is training done, but also During sport, the pain in the Achilles tendon can be felt.

This is followed by the physical examination, during which the doctor looks at the Achilles tendon and scans it. In Achillodynie often a thickening of the Achilles tendon and small nodules can be found. In addition, the physician can check whether certain foot movements in the Achilles tendon cause pain.

Another way to make the diagnosis, offers the ultrasound examination. On the screen, a present Achillodynie is recognizable. Likewise, an MRI examination can provide information. In this way, inflammation and the smallest tears in the Achilles tendon can be displayed in detail.

complications

An achillodynia is understood as a painful overload of the Achilles tendon. The pain usually occurs in the morning after getting up. At times the foot seems to crunch when moved. For prolonged complaints, the pain may also occur at night during the rest period.

Walking ability is increasingly limited the longer the symptom is ignored. The pain forces the person in a kind of Spitzfußstellung, so that the tendon is relieved. The complication is a permanent pain due to the heavily thickened Achilles tendon. Problems with the Achilles tendon can get older people as well as athletes after a longer training break.

In particular, rapid and spontaneous stress changes irritate the Achilles tendon. This must be able to withstand the strong tensile forces at any time. The tendon ensures that the heel raises and lowers while running, jumping, dancing and hiking. If the symptom is not consistently treated medically, there is a risk of chronic inflammation of the tendon, which causes further complications.

A heel spur threatens, the tendon tissue calcified and may even tear. Furthermore, the process of degeneration can affect the surrounding tissue, blood vessels and nerves. It takes many weeks for an achillodynia to heal. During this time, the patient must relieve the Achilles tendon and receives depending on the findings, a drug to reduce pain and inflammation.

When should you go to the doctor?

Achillodynia should be examined by a doctor. Not always a treatment is necessary. With the help of an examination, however, consequential damage and other painful complications can be avoided and limited. Because of this, pain in this region of the body should not go untreated. Especially in another effort may cause inflammation or cracks, which lead to a restriction of movement.

The person concerned should then consult a doctor if it comes in the lower legs or heels to pain that occur under stress. In most cases, the body looks very stiff after getting up in the morning. This complaint may also be a symptom of achillodynia and should be investigated in any case. The other complaints usually occur during daily stress or certain sports. A doctor must also be consulted if in addition to the Achillodynie also a malposition of the foot is present or if the person suffering from obesity.

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Treatment & Therapy

In general, the treatment of achillodynia is purely conservative, not on the surgical path. Only if the treatment is unsuccessful, surgery is necessary in rare cases. Conservative therapy aims to relieve the Achilles tendon, especially in acute conditions. For this, the triggering load, such as jogging, must first be interrupted to protect the foot.

Only when the pain has subsided completely, he may be fully used again. In addition, the doctor can administer painkillers. Also useful are special insoles for the shoes and exercises that can be learned in physiotherapy and show the person concerned how the foot is properly loaded. In surgical treatment of achillodynia, either the tendon skin is split or parts of the altered tissue are removed.

Outlook & Forecast

First and foremost, achillodynia causes relatively severe pain in the patient. This pain occurs especially in the lower leg or on the heel. Due to the pain, there are usually strong restrictions on movement. Thus, ordinary activities and sporting activities for the person concerned are no longer readily possible.

If the pain also occurs in the form of rest pain, it can lead to sleep problems. The Achilles tendon is very stiff, especially in the morning after waking up. In most cases, the pain does not disappear by itself and there is no spontaneous cure.

With another load, the pain increases. This can lead to infection and inflammation without treatment. This further restricts the movement of the patient and in some cases the person concerned can no longer perform any sports activities after the treatment.

In most cases, the treatment of achillodynia leads to a positive course of the disease. This is done mainly with the help of medication and physiotherapy. In severe cases, the tissue can also be removed. The life expectancy is not changed by the Achillodynie.

prevention

Achillodynia can best be prevented if over-and under-loading during exercise is avoided. The training should be increased slowly, because the body takes some time to get used to new stimuli. In addition, it is important to give the organism enough time to regenerate between workouts. It is also important to pay attention to suitable sports shoes and to consider their service life.

Over time, the sole can change and lead to bad stress. After all, it's important to listen to the body, because it's important to understand pain in the Achilles tendon as a warning signal, rather than ignoring it. Common complaints can be an indication of achillodynia.

aftercare

The pain states of achillodynia are usually closely related to the stress on the relevant structures. Therefore, also in the aftercare a focus must be placed on not burdening the tissue too early and, above all, not overburdening it. This is especially true for athletes who, because of their ambitions, often tend to start their training too early, thereby risking a recurrence.

If you train again, it is essential to pay attention to consistent warm-up and stretching exercises for the respective area during the aftercare. Resumption of stress should be discussed with the orthopedist or family doctor. Appropriate footwear is very important after an achillodynia.

To avoid in this context, especially the tendon shortening, which could bring the Achillodynie back to flare up. Shoes with higher heels may favor this shortening. Rehafach shops and orthopedic shoemakers are the right address for the right footwear.

Sport and exercise, which stresses the calf muscles, automatically affects the area of ​​the Achilles tendon. Therefore, it may be beneficial in the context of aftercare to switch to other sports than the usual, if the basic condition is to be rebuilt. Massage of the calf muscles counteract cramps, which could negatively affect the area of ​​the Achilles tendon. When convulsive, magnesium is a tried and tested remedy.

You can do that yourself

Since achillodynia usually occurs due to a (too) heavy load on the Achilles tendon, it is possible for those affected to take preventive measures. When the strain is gone, the achillodynia disappears in most cases. Accordingly, until the complete lack of pain, the triggering sport or the triggering activity should be consistently dispensed with. Most of the symptoms disappear after a few days.

To prevent achillodynia, athletes should be careful to maintain adequate recovery periods between workouts. In addition, it is important to warm up intensively against possible stress and to avoid overloading the body if possible. Already adhering to these basic rules, damage to the Achilles tendon can be reduced or the regeneration promoted. If pain occurs after exercise, it may help to cool the Achilles tendon. To protect the tendon from stress, kinesiological tapes may be suitable.

In addition, the right footwear can help in everyday life, as well as in training. For foot deformities, an orthopedic shoemaker is the right place to go, otherwise a specialist shop. Women should not wear too many and too long heels. This can lead to tendon shortening, which subsequently causes achillodynia.

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