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Achilles tendinitis

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activities. Other risk factors include gender, age, improper stretching, and overuse. Another risk factor is any congenital condition in which an individual's legs rotate abnormally, which in turn causes the lower extremities to overstretch and contract; this puts stress on the Achilles tendon and will eventually cause Achilles tendinitis.
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This photo demonstrates a calf raise exercise that can be performed to strengthen two of the major ankle plantar flexor muscles, the gastrocnemius and the soleus. This exercise can be performed with minimal to no equipment. A step can be added under the foot to enhance range of motion and weights can
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or paratendon. When an injury occurs to the tendon, cells from surrounding structures migrate into the tendon to assist in repair. Some of these cells come from blood vessels that enter the tendon to provide direct blood flow to increase healing. With the blood vessels come nerve fibers. Researchers
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Achilles tendinitis is thought to have physiological, mechanical, or extrinsic (i.e. footwear or training) causes. The Achilles tendon has a generally poor blood supply throughout its length, as measured by the number of vessels per cross-sectional area. Blood is supplied via the synovial sheaths
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to support them, namely pre-exercise stretching. Strengthening calf muscles, avoiding over-training, and selecting more appropriate footwear are more well-regarded options. Running mechanics can be improved with simple exercises that will help runners avoid Achilles injury. Treatment typically
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Risk factors include participating in a sport or activity that involves running, jumping, bounding, and change of speed. Although Achilles tendinitis is mostly likely to occur in runners, it also is more likely in participants in basketball, volleyball, dancing, gymnastics and other athletic
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before beginning an exercise session is often recommended, however evidence to support this practice is limited. Prevention of recurrence includes following appropriate exercise habits and wearing low-heeled shoes. In the case of incorrect foot alignment,
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can be used to properly position the feet. Footwear that is specialized to provide shock-absorption can be utilized to defend the longevity of the tendon. Achilles tendon injuries can be the result of exceeding the tendon's capabilities for
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Alfredson, H.; Ohberg, L.; Forsgren, S. (Sep 2003). "Is vasculo-neural ingrowth the cause of pain in chronic Achilles tendinosis? An investigation using ultrasonography and colour Doppler, immunohistochemistry, and diagnostic injections".
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Demonstration of the right foot in pronation, neutral and supinated subtalar joint placements. Over-pronation (excessive pronation) occurs when the ankle begins to roll inward by more than 5 degrees, demonstrated with the
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Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping, occurs both laterally and bilaterally, and is often induced in a single ankle by trauma. It is also a known side effect of
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including Alfredson and his team in Sweden believe these nerve fibers to be the cause of the pain - they injected local anaesthetic around the vessels and this decreased significantly the pain in the Achilles tendon.
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that surround it. This lack of blood supply can lead to the degradation of collagen fibers and inflammation. Tightness in the calf muscles has also been known to be involved in the onset of Achilles tendinitis.
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varies among different ages and groups of people. Achilles tendinitis is most commonly found in individuals aged 30–40 Runners are susceptible, as well as anyone participating in sports, and men aged 30–39.
262:. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiff the following day, as swelling impinges on the movement of the tendon. 1778:
Kainberger, F; Fialka, V; Breitenseher, M; Kritz, H; Baldt, M; Czerny, C; Imhof, H (1996). "Differential diagnosis of diseases of the Achilles tendon. A clinico-sonographic concept".
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intensity too soon. Another consideration would be the use of improper or worn-down footwear, which lack the necessary support to maintain the foot in the natural/normal pronation.
2206: 1647:"The effectiveness of extracorporeal shockwave therapy in common lower limb conditions: a systematic review including quantification of patient-rated pain reduction" 1944: 203:. It is accompanied by alterations in the tendon's structure and mechanical properties. The most common symptoms are pain and swelling around the back of the 1427: 207:. The pain is typically worse at the start of exercise and decreases thereafter. Stiffness of the ankle may also be present. Onset is generally gradual. 265:
Achilles tendon injuries can be separated into insertional tendinopathy (20%–25% of the injuries), midportion tendinopathy (55%–65%), and proximal
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There are several simple actions that individuals can take to prevent or reduce tendinitis. Though commonly used, some of these have limited or no
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refers to repeated stress and strain, which is likely the case in endurance runners. Overuse can simply mean an increase in running, jumping or
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of the tendon and lengthen the musculotendinous junction, decreasing the amount of strain experienced with ankle joint movements. This
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Symptoms can vary from an ache or pain and swelling in the local area of one or both ankles, or a burning that surrounds the whole
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McCrory J. L.; Martin D. F.; Lowery R. B.; Cannon D. W.; Curl W. W.; Read Jr H. M.; Hunter D.M.; Craven T.; Messier S. P. (1999).
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Because the Achilles tendon does not have good blood supply, injuries can be slow to heal. The tendon receives nutrients from the
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within the Achilles tendon at its calcaneal insertion. The Achilles tendon is wider than normal, further suggesting inflammation.
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Hubbard, MJ; Hildebrand, BA; Battafarano, MM; Battafarano, DF (June 2018). "Common Soft Tissue Musculoskeletal Pain Disorders".
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may increase range of motion, but there is only weak evidence for the direct treatment of stiffness. Other treatments include:
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Hess G.W. (2009). "Achilles Tendon Rupture: A Review of Etiology, Population, Anatomy, Risk Factors, and Injury Prevention".
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Park, DY; Chou, L (December 2006). "Stretching for prevention of Achilles tendon injuries: a review of the literature".
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Walking gait cycle starting with the left leg demonstrated. The loading cycle is where foot pronation naturally occurs.
865: 2364: 1585:"JBJS | Limited Evidence Supports the Effectiveness of Autologous Blood Injections for Chronic Tendinopathies" 521: 387: 2404: 266: 2241: 379: 214:, but also occurs due to injury. Other risk factors include trauma, a lifestyle that includes little exercise, 2374: 2094: 161: 2342: 2157: 2038: 391: 156: 2337: 319: 2369: 2084: 2074: 1997: 1953: 416: 375: 296: 231: 219: 149: 127: 1447:"Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial" 2246: 2017: 2004: 1987: 1859: 906: 436: 334: 238: 1412:
G T Allison, C Purdam. Eccentric loading for Achilles tendinopathy — strengthening or stretching?
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Peters, JA; Zwerver, J; Diercks, RL; Elferink-Gemser, MT; van den Akker-Scheek, I (March 2016).
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and strength of the tendon, which will assist in resisting the forces that are applied.
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During the loading phase of the running and walking cycle, the ankle and foot naturally
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Kannus P (1997). "Etiology and pathophysiology of chronic tendon disorders in sports".
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Floyd, R.T. (2009). Manual of Structural Kinesiology. New York, NY: McGraw Hill
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training method is especially important for individuals with chronic Achilles
422: 1331: 1062: 959: 681: 666:"Current Clinical Concepts: Conservative Management of Achilles Tendinopathy" 2323: 1978: 1905: 1446: 479: 427: 383: 1672: 1570: 1529: 1470: 1391: 1368:"Chronic Achilles Tendinosis: Recommendations for Treatment and Prevention" 1339: 1257: 1213: 1080: 1028: 977: 826: 774: 699: 617: 1799: 1791: 1761: 1712: 1510: 1161: 1118: 950: 892: 2064: 1614:
de Vos RJ, van Veldhoven PL, Moen MH, Weir A, Tol JL, Maffulli N (2012).
866:"Avoid Achilles injuries by adding these three exercises to your routine" 483: 315: 1922: 58:
Drawing of Achilles tendinitis with the affected part highlighted in red
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Korakakis, V; Whiteley, R; Tzavara, A; Malliaropoulos, N (March 2018).
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Leach R. E.; James S.; Wasilewski S. (1981). "Achilles tendinitis".
390:(MRI) can determine the extent of tendon degeneration, and may show 1188:"Etiologic factors associated with Achilles tendinitis in runners" 1009: 405: 357: 285: 276: 259: 204: 44:
Achilles tendinopathy, Achilles tendonitis, Achilles tenosynovitis
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Kearney, RS; Parsons, N; Metcalfe, D; Costa, ML (26 May 2015).
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injections. These can also increase the risk of tendon rupture.
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is a type of mechanical mechanism that can lead to tendinitis.
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Kader, D.; Saxena, A.; Movin, T.; Maffulli, N. (2002-08-01).
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which is classified as the degeneration of collagen fibers.
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Hintermann B., Nigg B. M. (1998). "Pronation in runners".
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Kvist, M (1991). "Achilles tendon injuries in athletes".
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may also be helpful, but evidence for either is limited.
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Performing consistent physical activity will improve the
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shows calcification deposits within the tendon at its
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The evidence to support injection therapies is poor.
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class. Diagnosis is generally based on symptoms and
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(1996). 1555:The Cochrane Database of Systematic Reviews 1192:Medicine and Science in Sports and Exercise 841:"Achilles tendinitis - Symptoms and causes" 2311: 2182: 2142: 1966: 1945: 1931: 1923: 1823: 1541: 1539: 1361: 1359: 1357: 1313: 1311: 1181: 1179: 1040: 1038: 748: 746: 591: 498:routine designed to strengthen the tendon. 49: 32: 1751: 1662: 1519: 1509: 1203: 1070: 1018: 1008: 967: 949: 816: 794: 792: 719: 717: 715: 713: 711: 709: 689: 659: 657: 655: 589: 587: 585: 583: 581: 579: 577: 575: 573: 571: 442:Eccentric strengthening exercises of the 80:Pain, swelling around the affected tendon 1993:Stenosing tenosynovitis (Trigger finger) 1686: 1684: 1682: 1277: 1275: 1051:Journal of the Royal Society of Medicine 805:Journal of Science and Medicine in Sport 653: 651: 649: 647: 645: 643: 641: 639: 637: 635: 470:Treatment typically involves rest, ice, 1693:The American Journal of Sports Medicine 1142:Scandinavian Journal of Sports Medicine 567: 533:Tentative evidence supports the use of 27:Medical condition of the ankle and heel 1092: 1090: 318:by approximately 5 degrees. Excessive 1736:"Incidence of Achilles Tendon Injury" 1426:Munteanu, Shannon (3 November 2014). 472:non-steroidal antiinflammatory agents 244:non-steroidal antiinflammatory agents 173:non-steroidal antiinflammatory agents 7: 450:muscles are utilized to improve the 411:be added to increase the resistance 303:, as are other types of tendinitis. 2197:Adhesive capsulitis of the shoulder 1366:Alfredson H., Lorentzon R. (2012). 1238:Knee Surg Sports Traumatol Arthrosc 1651:British Journal of Sports Medicine 1451:British Journal of Sports Medicine 1432:British Journal of Sports Medicine 1154:10.1111/j.1600-0838.1997.tb00123.x 938:British Journal of Sports Medicine 362:Calcification deposits forming an 25: 1283:"Insertional Achilles Tendinitis" 1384:10.2165/00007256-200029020-00005 1205:10.1097/00005768-199910000-00003 1111:10.2165/00007256-199826030-00003 535:extracorporeal shockwave therapy 729:MSD Manual Professional Edition 1563:10.1002/14651858.CD010960.pub2 755:Foot & Ankle International 501:Application of a boot or cast. 1: 2202:Shoulder impingement syndrome 2045:Tenosynovial giant cell tumor 2024:Synovial osteochondromatosis 1664:10.1136/bjsports-2016-097347 1492:Baumgart, Christian (2019). 1463:10.1136/bjsports-2014-093845 670:Journal of Athletic Training 1320:Foot & Ankle Specialist 818:10.1016/j.jsams.2015.03.008 664:Silbernagel, Karin (2020). 522:Autologous blood injections 297:fluoroquinolone antibiotics 104:Noninsertional, insertional 2426: 1705:10.1177/036354658100900204 1445:Munteanu, Shannon (2015). 767:10.1177/107110070602701215 388:Magnetic resonance imaging 1753:10.3109/17453679608994688 1250:10.1007/s00167-003-0391-6 610:10.1016/j.pop.2018.02.006 267:musculotendinous junction 222:, and medications of the 57: 48: 2242:Iliotibial band syndrome 1332:10.1177/1938640009355191 1063:10.1177/0141076809701004 682:10.4085/1062-6050-356-19 380:Projectional radiography 322:(over 5 degrees) in the 2375:Aggressive fibromatosis 2365:Dupuytren's contracture 162:Achilles tendon rupture 2039:villonodular synovitis 1620:bmb.oxfordjournals.org 1591:. 2012. Archived from 412: 392:differential diagnoses 367: 291: 283: 157:Differential diagnosis 148:Based on symptoms and 2410:Soft tissue disorders 1954:Soft tissue disorders 1792:10.1007/s001170050037 1511:10.3390/sports7010027 951:10.1136/bjsm.36.4.239 725:"Achilles Tendinitis" 409: 361: 320:pronation of the foot 289: 280: 197:Achilles tendinopathy 130:, medications of the 2370:Plantar fibromatosis 1998:De Quervain syndrome 376:physical examination 242:involves rest, ice, 220:rheumatoid arthritis 128:rheumatoid arthritis 2252:Achilles tendinitis 2247:Patellar tendinitis 2018:osteochondromatosis 2005:Transient synovitis 1988:Calcific tendinitis 335:plyometric exercise 239:scientific evidence 193:Achilles tendinitis 36:Achilles tendinitis 18:Achilles tendonitis 2153:Ligamentous laxity 1886:External resources 997:Arthritis Research 868:. 3 December 2019. 496:eccentric exercise 413: 368: 292: 284: 254:Signs and symptoms 199:, is soreness the 2392: 2391: 2388: 2387: 2303: 2302: 2299: 2298: 2212:Rotator cuff tear 2132: 2131: 2124:Calcific bursitis 1920: 1919: 1740:Acta Orthopaedica 1626:on April 15, 2013 1595:on March 29, 2012 1198:(10): 1374–1381. 881:Ann Chir Gynaecol 190: 189: 144:Diagnostic method 30:Medical condition 16:(Redirected from 2417: 2405:Overuse injuries 2312: 2280: 2235: 2190: 2183: 2143: 1967: 1947: 1940: 1933: 1924: 1824: 1812: 1811: 1775: 1766: 1765: 1755: 1731: 1725: 1724: 1688: 1677: 1676: 1666: 1642: 1636: 1635: 1633: 1631: 1622:. 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Index

Achilles tendonitis

Specialty
Rheumatology
Symptoms
Risk factors
high-heel shoes
rheumatoid arthritis
fluoroquinolone
steroid
Diagnostic method
examination
Differential diagnosis
Achilles tendon rupture
non-steroidal antiinflammatory agents
physical therapy
Achilles tendon
ankle
running
high-heel shoes
rheumatoid arthritis
fluoroquinolone
steroid
examination
scientific evidence
non-steroidal antiinflammatory agents
physical therapy
joint
musculotendinous junction

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