Achilles Tendonitis
Definition:
Inflammation of the Achilles tendon, commonly found in athletes.
Symptoms:
The patient presents with a sharp, nagging pain above the heel. Limited ankle flexibility and inflammation over the affected area are often present.
Biomechanical etiology:
Achilles tendonitis commonly occurs from shearing and tractional forces placed on the Achilles tendon above the heel. When the foot accelerates into an excessively pronated position the calcaneus everts, causing an increase in medial tendo-achilles traction resulting in transverse shearing. This mechanism has been linked to Sever's Disease, Restless Leg Syndrome and 'growing pains' etc.
Treatment:
By preventing excess pronation orthotics reduce medial tendo-achilles traction, therefore helping to alleviate the problem.
Additional treatment: Ice therapy (15 minutes, 3 times a day), rest from running.
Exercises:
- Achilles stretch - stand with legs straight on balls of your feet on a curb or rung of ladder. Drop heels down and hold position for 20-25 seconds per leg in extended and flexed positions.
- Stretching of the calf muscles.
Pes Planus (Flat Feet)
Biomechanical etiology:
A true flat foot is rare. Generally, a flat-footed person is only suffering from a functional flat foot caused by excess pronation. Excess pronation causes the foot's arch to collapse and elongate giving the appearance of a flat foot. A functional flat foot is quite common and generally exhibits symptoms ranging from sore/tired feet to general leg fatigue and body aches.
Treatment:
Orthotics control excess pronation by preventing excess calcaneal eversion during the contact phase of gait. This prevents secondary unlocking of the mid-tarsal joints during the mid-stance phase of gait which is commonly representative of Pes Planus.
Summary
Achilles Tendonitis:
Inflammation of the Achilles tendon, caused by increased traction on the Achilles tendon due to excessive subtalar joint pronation and calcaneal eversion.
Treatment:
Pre-molded orthotic (sport for athletes) or custom full-length orthotic.
Other:
stretching of Achilles and calf muscles; ice therapy