Achilles Tendinitis (sometimes referred to as Achilles Tendonitis) is the inflammation of the Achilles tendon. The Achilles tendon is the thickest in the human body, and is used extensively in movements around the foot. As a result, it is prone to being overused by physical activities such as running and jumping which involve repetitive movements in the area. The pain that is experienced as a result of the condition is from the torn fibers in the tendon.
Overuse injuries are a particularly common cause, wear gradual wear and tear damages the fibers in the Achilles tendon. There is not much to prevent tendinitis from overuse other than to limit the usage of the tendon, but gradually increasing the exposure to exercises that work the Achilles tendon can increase its strength and elasticity, and developing a better resistance to acute tendinitis.
Another common cause is introducing a sudden change in physical activity. For example, a shift from a relatively sedentary lifestyle to high-intensity physical workouts can damage the Achilles tendon which has not had time to strengthen. Another example might be a change in the training surface, which can change the amount of pronation/supination during the loading phase.
The best way to mitigate damage to the tendon is to stretch and warm-up the tendon so that its capacity to stretch is increased and damage from an excessive stretch becomes less likely. The amount of wear to the tendon for a given amount of time training can be reduced by changing the training surface or footwear, for example trainers with shock-absorption.
If tendinitis develops, it is common to have stiffness and a reduced range of motion around the foot the following day. To aid faster recovery, the patient should refrain from strenuous physical activity, which could make symptoms worse and develop into Achilles tendon rupture. Cold compression therapy can be used to reduce swelling and pain. For more serious cases of the condition, a visit to the doctor is advised to prevent further damage.
Sports that involve high amounts of lunging and jumping are likely to cause Achilles Tendinitis. However, sports where the athlete performs a large amount of jumping and landing, such as basketball and volleyball, are also likely to cause patellar tendinitis (colloquially known as jumper’s knee). This is inflammation of the tendons in the inferior patellar region, commonly caused by overuse of the extensor mechanism in the knee. Like Achilles tendinitis, the patient should not engage in further physical activity as the damage from microtears exceeds the rate of recovery.
According to Vertical Jump Development, users of the Vert Shock program were significantly less prone to developing Patellar and Achilles tendinitis following completion of the program. The program involved repetitive jumping with a focus on increasing the elasticity of tendons surrounding both the knee and ankle.
Ankle sprains are where a single or multiple ligaments of the ankle are torn, or partially torn. It has painful symptoms, but distinguishable from those resulting from broken bone. White blood cells will flow to the area of damage, causing inflammation to the area. Further, blood vessels will release fluid to the area, causing swelling and pain. As a result of the injury, nerves close to the area of damage become more sensitive. Less painful symptoms are also present, including redness, increased warmth and decreased mobility around the joint.
What causes ankle sprain?
Excessive stress on the ligaments around the ankle are most likely to tear the ligaments and cause ankle sprain. Rolling the ankle joint can be especially dangerous, and although the ankle possesses a natural resistance to this movement, when it occurs it has a high likelihood of producing ankle sprain. However, even simple movements around the foot which cause the ligaments near the joint to become hyper-active can produce ankle sprain. Normally, ankle sprain comes after either an extended period of activity where the supporting mechanisms are ‘worn down’, or right after a long period of inactivity in the region. Side to side movements exert the most strain on the ankle joints, and are most likely to cause ankle sprain.
The degree of vulnerability to ankle sprain depends on many factors. Weak muscles and tendons, lax ligaments, slow neural responses to correcting off-balance stances and shoes with poor arch and ankle support are examples of factors that can increase one’s chances of a sprained ankle.
Managing Ankle Sprain
If one is affected by ankle sprain, it is important to prevent more severe injury and allow the ligaments to recover. The acronym ‘PRICE’ is sometimes used for basic therapy that should be used to manage pain, allow recovery and reduce risk of further injury:
Protection: Wear shoes with strong heel and ankle support.
Rest: Avoid activities that cause stress on the ankle joint.
Ice: Apply ice close to the source of pain using ice wrapped in a towel. Do not do this when asleep.
Compression: Wrap the sprained ankle to reduce swelling and the amount of mobility in that area. Unwrap the area before sleep.
Elevation: Raise the leg to reduce swelling.
Additionally, painkillers can be used to minimize pain symptoms. If pain is severe, a doctor can prescribe you a stronger painkiller or NSAIDs.
Although exaggerated or painful movements around the ankle joint should be avoided during a sprained ankle, healing is faster when you gradually reintroduce slow and careful movements around the area. Physiotherapy is sometimes recommended for those with severe ankle sprain which would otherwise have a long recovery time.
The length of time ankle sprains lasts varies with the severity of the damage inflicted to the ligaments. Typically, the person can return to basic activities within 1-2 weeks. Going back activities that cause more stress to the ankle, like sports or long walks, should be avoided for a few more weeks as the ligaments are at a high risk of injury. Activities which cause the most stress to the ankle (e.g. Soccer, fast-paced sports, plyometrics) should be avoided completely until full recovery is certain.