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Achilles Tendon Pain

What is the Achilles tendon?

The Achilles tendon connects the calf muscle to the heel bone. It lets you rise up on your toes and push off when you walk or run.

What are common Achilles tendon problems?

The two main problems found in the Achilles tendon are:

  • Achilles tendinopathy. Achilles tendinopathy includes one of two conditions:
    • Tendinitis. This actually means “inflammation of the tendon,” but inflammation is rarely the cause of tendon pain.
    • Tendinosis. This refers to tiny tears (microtears) in the tissue in and around the tendon caused by overuse. In most cases Achilles tendon pain is the result of tendinosis, not tendinitis. Some experts now use the term tendinopathy to include both inflammation and microtears. But many doctors may still use the term tendinitis to describe a tendon injury.
  • Achilles tendon tear or rupture. An Achilles tendon also can partially tear orcompletely tear (rupture) camera. A partial tear may cause mild or no symptoms. But a complete rupture causes pain and sudden loss of strength and movement.

Problems with the Achilles tendon may seem to happen suddenly. But usually they are the result of many tiny tears to the tendon that have happened over time.

What causes Achilles tendon problems?

Achilles tendon problems are most often caused by overuse or repeated movements. These movements can happen during sports, work, or other activities. For example, if you do a lot of pushing off or stop-and-go motions when you play sports, you can get microtears in the tendon. Microtears can also happen with a change in how long, hard, or often you exercise. Microtears in the tendon may not be able to heal quickly or completely.

Being out of shape or not warming up before exercising may also cause Achilles tendon problems. So can shoes with poor arch supports or rigid heels.

An Achilles rupture is most often caused by a sudden, forceful motion that stresses the calf muscle. This can happen during an intense athletic activity or even during simple running or jumping. Middle-aged adults are especially likely to get this kind of injury.

A rupture most often occurs in sports such as basketball, racquet sports (including tennis), soccer, and softball. A tendon already weakened by overstretching, inflammation, or small tears is more likely to rupture.

What are the symptoms?

Symptoms of Achilles tendon problems include swelling in the ankle area and mild or severe pain. The pain may come on gradually or may only occur when you walk or run. You may have less strength and range of movement in the ankle.

A rupture of the Achilles tendon may cause a sudden, sharp pain. Most people feel or hear a pop at the same time. Swelling and bruising may occur, and you may not be able to point your foot down or stand on your toes.

How are Achilles tendon problems diagnosed?

Your doctor can tell if you have an Achilles tendon problem by asking questions about your past health and checking the back of your leg for pain and swelling. The doctor may ask: How much pain do you have? How did your injury happen? Have you had other injuries in the ankle area?

If your symptoms are severe or do not improve with treatment, your doctor may want you to get an X-ray, ultrasound scan, or MRI.

How are they treated?

Treatment for mild Achilles tendon problems includes rest, over-the-counter pain medicine, and stretching exercises. You may need to wear well-cushioned shoes and change the way you play sports so that you reduce stress on the tendon. Early treatment works best and can prevent more injury.

Even in mild cases, it can take weeks to months of rest for the tendon to repair itself. It’s important to be patient and not return too soon to sports and activities that stress the tendon.

Treatment for severe problems, such as a torn or ruptured tendon, may include surgery or a cast, splint, brace, walking boot, or other device that keeps the lower leg from moving. Exercise, either in physical therapy or in a rehab program, can help the lower leg get strong and flexible again. The tendon will take weeks to months to heal.

Although treatment for Achilles tendon problems takes time, it usually works. Most people can return to sports and other activities.

Cure your Achilles Tendonitis today. Call us +65 64712744 or SMS +65 92357641 to schedule for an appointment.

Sever’s Disease (Heel Pain in Children)

What Is Calcaneal Apophysitis?
Calcaneal apophysitis is a painful inflammation of the heel’s growth plate. It typically affects children between the ages of 8 and 14 years old, because the heel bone (calcaneus) is not fully developed until at least age 14. Until then, new bone is forming at the growth plate (physis), a weak area located at the back of the heel. When there is too much repetitive stress on the growth plate, inflammation can develop.

Calcaneal278Calcaneal apophysitis is also called Sever’s disease, although it is not a true “disease.” It is the most common cause of heel pain in children, and can occur in one or both feet.

Heel pain in children differs from the most common type of heel pain experienced by adults. While heel pain in adults usually subsides after a period of walking, pediatric heel pain generally doesn’t improve in this manner. In fact, walking typically makes the pain worse.

Causes
Overuse and stress on the heel bone through participation in sports is a major cause of calcaneal apophysitis. The heel’s growth plate is sensitive to repeated running and pounding on hard surfaces, resulting in muscle strain and inflamed tissue. For this reason, children and adolescents involved in soccer, track, or basketball are especially vulnerable.

Other potential causes of calcaneal apophysitis include obesity, a tight Achilles tendon, and biomechanical problems such as flatfoot or a high-arched foot.

Symptoms
Symptoms of calcaneal apophysitis may include:

  • Pain in the back or bottom of the heel
  • Limping
  • Walking on toes
  • Difficulty running, jumping, or participating in usual activities or sports
  • Pain when the sides of the heel are squeezed

Diagnosis
To diagnose the cause of the child’s heel pain and rule out other more serious conditions, the foot and ankle surgeon obtains a thorough medical history and asks questions about recent activities. The surgeon will also examine the child’s foot and leg. X-rays are often used to evaluate the condition. Other advanced imaging studies and laboratory tests may also be ordered.

Treatment
The surgeon may select one or more of the following options to treat calcaneal apophysitis:

  • Reduce activity. The child needs to reduce or stop any activity that causes pain.
  • Support the heel. Temporary shoe inserts or custom orthotic devices may provide support for the heel.
  • Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce the pain and inflammation.
  • Physical therapy. Stretching or physical therapy modalities are sometimes used to promote healing of the inflamed issue.
  • Immobilization. In some severe cases of pediatric heel pain, a cast may be used to promote healing while keeping the foot and ankle totally immobile.

Often heel pain in children returns after it has been treated because the heel bone is still growing. Recurrence of heel pain may be a sign of calcaneal apophysitis, or it may indicate a different problem. If your child has a repeat bout of heel pain, be sure to make an appointment with your foot and ankle surgeon.

Can Calcaneal Apophysitis Be Prevented?
The chances of a child developing heel pain can be reduced by:

  • Avoiding obesity
  • Choosing well-constructed, supportive shoes that are appropriate for the child’s activity
  • Avoiding or limiting wearing of cleated athletic shoes
  • Avoiding activity beyond a child’s ability.

GET PROFESSIONAL OPINION AND TREATMENT ABOUT YOUR CHILD HEEL PAIN. CALL US +65 6471 2744 OR SMS TO +65 92357641 FOR APPOINTMENT

Plantar Fasciitis (Heel Pain / Sole Pain)

Plantar Fasciitis is a painful condition resulting in pain under the heel. It is often caused by overuse of the plantar fascia or arch tendon of the foot. We explain symptoms, treatment, exercises, sports massage and more.

The Plantar Fascia is a broad, thick band of tissue that runs from under the heel to the front of the foot.  It is also known as a heel spur although they are not strictly the same. A heel spur is a bony growth that occurs at the attachment of the plantar fascia to the heel bone (calcaneus). A heel spur can be present (through repetitive pulling of the plantar fascia) on a foot with no symptoms at all and a painful heel does not always have a heel spur present.

The condition is traditionally thought to be inflammation. This is now believed to be incorrect due to the absence of inflammatory cells within the fascia. The cause of pain is now thought to be degeneration of the collagen fibres close to the attachment to the calcaneus (heel bone).

Plantar fasciitis symptoms

Symptoms of the plantar fasciitis include pain under the heel and usually on the inside, at the origin of the attachment of the fascia.  There can be pain when pressing on the inside of the heel and sometimes along the arch.  The pain is usually worse first thing in the morning as the fascia tightens up overnight and after a few minutes it eases as the foot gets warmed up.

As the condition becomes more severe the pain can get worse throughout the day if activity continues.  Stretching the plantar fascia may be painful and sometimes there may also be pain along the outside border of the heel. This may occur due to offloading the painful side of the heel by walking on the outside border of the foot. It may also be associated with the high impact of landing on the outside of the heel if you have high arched feet.

Tarsal tunnel syndrome symptoms can be very similar. If you have any shooting pain or tingling / numbness then consider this as an alternative diagnosis.

Causes

Plantar fasciitis or heel spurs are common in sports which involve running, dancing or jumping. Runners who overpronate (feet rolling in or flattening) are particularly at risk as the biomechanics of the foot pronating causes additional stretching of the fascia.

The most common cause is very tight calf muscles which leads to prolonged and / or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it looses flexibility and strength

Some practitioners think overpronation can always be determined by the dropping and rolling in of the arch. This is not always the case. Sometimes it can only be seen with foot scans, especially if the patient has a high arched foot.

Other causes include low arch or high arched feet (pes planus / cavus) and other biomechanical abnormalities including oversupination which should be assessed by a podiatrist / physiotherapist / biomechanist.

Excessive walking in footwear which does not provide adequate arch support has been attributed. Footwear for plantar fasciitis – both prevention and treatment – should be flat, lace-up and with good arch support and cushioning.

Overweight individuals are more at risk of developing the condition due to the excess weight impacting on the foot.

Plantar fasciitis treatment

Although there is no single cure, many treatments can be used to ease pain.  In order to treat it effectively for the long-term, the cause of the condition must be corrected.

What can the athlete do?

  • Rest until it is not painful. It can be very difficult to rest the foot as most people will be on their feet during the day for work. By walking on the painful foot you are continually aggravating the injury and increasing inflammation.
  • A good plantar fasciitis taping technique can help support the foot relieving pain and helping it rest
  • Apply ice or cold therapy to help reduce pain and inflammation. Cold therapy can be applied regularly until symptoms have resolved.
  • Plantar fasciitis exercises in particular stretching the fascia is an important part of treatment and prevention. Simply reducing pain and inflammation alone is unlikely to result in long term recovery. The fascia tightens up making the origin at the heel more susceptible to stress
  • A night splint is an excellent product which is worn overnight and gently stretches the calf muscles preventing it from tightening up overnight.

What can a Sports Injury Professional do?

  • Prescribe anti-inflammatory medication.
  • Perform gait analysis to determine if you overpronate or oversupinate and prescribe orthotics or insoles. An insole can restore normal foot biomechanics if overpronation is a problem.
  • Tape the foot and instruct the athlete how to apply taping, this is an excellent way of allowing the foot to rest.
  • Apply sports massage techniques to reduce the tension and also stretch the calf muscles.
  • Prescribe exercises to help stretch the fascia and strengthen it once pain free.
  • Use a corticosteroid injection – usually best combined with biomechanical correction with orthotics.
  • X ray to see if there is any bone growth (calcification). An X-ray may be able to show bone growth which may be a cause of pain but research has shown that the presence of a bony growth does not necessarily mean the athlete will feel pain. Bony growth can worsen even after symptoms have completely resolved.
  • Use Extracorporeal Shock Wave Therapy.
  • Operate if symptoms do not resolve. This is more common for patients with a rigid high arch where the plantar fascia has shortened to benefit from surgery.

STOP YOUR HEEL PAIN TODAY. CALL +65 6471 2744 or SMS to +65 9235 7641 for Appointment now.

Plantar Fasciitis (Heel Pain)

Plantar Fasciitis is a painful condition resulting in pain under the heel. It is often caused by overuse of the plantar fascia or arch tendon of the foot. It is a very common condition and can be difficult to treat if not looked after properly.

Plantar Fasciitis and Heel Spurs

Plantar Fasciitis and Heel Spurs

What are the Signs and Symptoms?

  • Heel pain, under the heel and usually on the inside, at the origin of the attachment of the fascia.
  • Pain when pressing on the inside of the heel and sometimes along the arch.
  • Pain is usually worse first thing in the morning as the fascia tightens up overnight. After a few minutes it eases as the foot gets warmed up
  • As the condition becomes more severe the pain can get worse throughout the day if activity continues.
  • Stretching the plantar fascia may be painful.
  • Sometimes there may also be pain along the outside border of the heel. This may occur due to the offloading the painful side of the heel by walking on the outside border of the foot. It may also be associated with the high impact of landing on the outside of the heel if you have high arched feet.

What is Plantar Fasciitis?

The Plantar Fascia is a broad, thick band of tissue that runs from under the heel to the front of the foot.

Plantar fasciitis can also be known as a heel spur although they are not strictly the same. A heel spur is a bony growth that occurs at the attachment of the plantar fascia to the heel bone (calcaneus). A heel spur can be present (through repetitive pulling of the plantar fascia) on a foot with no symptoms at all and a painful heel does not always have a heel spur present.

Plantar fasciitis is traditionally thought to be an inflammatory condition. This is now believed to be incorrect due to the absence of inflammatory cells within the fascia. The cause of pain and dysfunction is now thought to be degeneration of the collagen fibres close to the attachment to the calcaneus (heel bone).

What Causes Plantar Fasciitis?

  • Plantar fasciitis or heel spurs are common in sports which involve running, dancing or jumping. Runners who overpronate (feet rolling in or flattening) are particularly at risk as the biomechanics of the foot pronating causes additional stretching of the plantar fascia.
  • The most common cause of plantar fasciitis is very tight calf muscles which leads to prolonged and / or high velocity pronation of the foot. This in turn produces repetitive over-stretching of the plantar fascia leading to possible inflammation and thickening of the tendon. As the fascia thickens it looses flexibility and strength.
  • Some practitioners think overpronation can always be determined by the dropping and rolling in of the arch. This is not always the case. Sometimes it can only be seen with foot scans, especially if the patient has a high arched foot.
  • Other causes include low arch or high arched feet (pes planus / cavus) and other biomechanical abnormalities including oversupination which should be assessed by a podiatrist / physiotherapist / biomechanist.
  • Excessive walking in footwear which does not provide adequate arch support has been attributed to plantar fasciitis. Footwear for plantar fasciitis – both prevention and treatment – should be flat, lace-up and with good arch support and cushioning.
  • Overweight individuals are more at risk of developing the condition due to the excess weight impacting on the foot.

Plantar Fasciitis Treatment

There is no single cure for plantar fasciitis. Whilst many treatments can be used to ease pain, in order to treat it effectively long-term, the cause of the condition must be corrected.

What can the athlete do?

  • Rest until it is not painful. It can be very difficult to rest the foot as most people will be on their feet during the day for work. By walking on the painful foot you are continually aggravating the injury and increasing inflammation.
  • A good plantar fasciitis taping technique can help support the foot relieving pain and helping it rest.
  • Apply ice or cold therapy to help reduce pain and inflammation. Cold therapy can be applied regularly until symptoms have resolved.
  • Plantar fasciitis exercises such as stretching the plantar fascia is an important part of treatment and prevention. Simply reducing pain and inflammation alone is unlikely to result in long term recovery. The plantar fascia tightens up making the origin at the heel more susceptible to stress.
  • A plantar fasciitis night splint is an excellent product which is worn overnight and gently stretches the calf muscles and plantar fascia preventing it from tightening up overnight.

CURE YOUR HEEL PAIN TODAY. Call +65 6471 2744 (24 Hours) FOR APPOINTMENT OR EMAIL TO: info@boneclinic.com.sg