Sports enthusiasts should protect your Achilles tendon and prevent Achilles tendonitis!

Author: Wu Yong, Chief Physician of Beijing Jishuitan Hospital

Reviewer: Li Jun, Chief Physician, Peking University First Hospital

In today's society where people are paying more and more attention to healthy living, a large number of people who are keen on sports have emerged. They are keen on running, playing badminton, square dancing, kicking shuttlecock, or mountain climbing. The colorful sports bring them a happy mood and high passion for life, but what sports enthusiasts need to be vigilant about is that Achilles tendonitis may have quietly approached you.

1. What is Achilles tendonitis?

The triceps surae extends distally to the calcaneus. The upper part is the muscle, and the lower part is the tendon, which is what we often call the Achilles tendon. Its insertion point is at the calcaneus, and it is about ten centimeters long.

Figure 1 Original copyright image, no permission to reprint

Achilles tendinitis is an inflammatory change in the tissues surrounding the Achilles tendon and changes in the Achilles tendon itself, causing morphological changes, such as thickening and hardening of the Achilles tendon. It is mainly due to repeated overstretching of the Achilles tendon, which causes chronic damage to the Achilles tendon and is difficult to recover in a short period of time, and gradually forms a degenerative change.

The main symptom of Achilles tendinitis is pain, which occurs in almost 100% of cases. When some people get up in the morning, their Achilles tendons will suddenly move after a night of rest without any activity or stretching, causing severe pain in the Achilles tendon; or when they suddenly get up and move after a rest during the day, the Achilles tendon will also be stretched and cause severe pain.

2. Which groups of people are most susceptible to Achilles tendonitis?

Achilles tendonitis is mainly caused by overuse of the Achilles tendon, so people who overuse the Achilles tendon are more likely to have Achilles tendonitis.

For example, athletes, or people who particularly like sports, such as running, badminton and other bouncing sports, such sports that excessively impact the Achilles tendon can easily cause Achilles tendonitis.

In addition, people whose occupations always interfere with or irritate the Achilles tendon, such as drivers, often extend their backs when stepping on the clutch or brake, which interferes with the Achilles tendon to a certain extent. They are also a high-risk group for Achilles tendonitis.

In addition, as people age, the Achilles tendon undergoes a degeneration process, and the risk of Achilles tendonitis in the elderly will also increase, especially for those who worked harder when they were young. Their Achilles tendons will degenerate, which can easily lead to Achilles tendonitis.

The age at which Achilles tendinitis develops, except for athletes, is mostly over 35 years old.

3. The pain above the back of the heel is suspected to be Achilles tendonitis. What examinations need to be done?

The doctor will ask about the medical history, do a physical examination, and see where the pain is to make a judgment. This is very important. The junction of the tendon and the bone causes some inflammatory reactions, which is called Achilles tendon insertion disease. It is different from the onset of Achilles tendinitis and needs to be differentiated.

In addition, some auxiliary examinations can be performed, such as X-rays, B-ultrasound, and even magnetic resonance imaging. These examinations are useful for determining whether it is Achilles tendon insertion disease or Achilles tendonitis, as well as for determining the range and degree of the lesion. So which of these three examinations is most commonly used?

X-rays are less effective and are mainly used to look at bones. B-ultrasound is now being used more and more because it is non-invasive, simple, inexpensive, and can be done at any time. In addition, B-ultrasound can also detect some special diseases. For example, the incidence of gout is very high now. Uric acid crystals can also be deposited at the junction of tendons and bones, and can also be deposited on the synovium of tendons. B-ultrasound examinations can detect them. If you want to judge Achilles tendonitis or Achilles tendon insertion disease more carefully and accurately, magnetic resonance imaging is very effective because soft tissues can be seen more clearly under magnetic resonance imaging.

4. Can Achilles tendonitis be cured completely? Will it recur?

Achilles tendonitis is a chronic disease that is difficult to treat. It requires active rehabilitation training, long-term exercise and protection. It also requires a change in lifestyle. For example, if you used to like running and playing ball, you can change to cycling and swimming. These sports can not only achieve the purpose of exercise, but also reduce stimulation to the Achilles tendon.

Achilles tendonitis can be cured. However, if you continue to overuse your Achilles tendon frequently after recovery, excessive activity will cause Achilles tendonitis again.

How to avoid the occurrence or recurrence of Achilles tendinitis? Before exercising, you should do more warm-up exercises, such as stretching, to warm up the Achilles tendon. This way, dancing or kicking shuttlecock will not easily cause injury. In addition, after excessive or large-scale activities, you should soak your feet in hot water at night to promote blood circulation. After exercise, you should maintain the Achilles tendon and do some relaxing massage or hot compress, which are all good for the Achilles tendon.