Question :

Heel pain when I straighten my leg and flex my foot:Possible Achilles Tendonitis

Dear Ask The Doctor:
I was in a yoga class and was stretching pre-class. I stretched my right leg out in front of me and set it on the ground and immediately felt a sharp shooting pain go through the back of my heel. The pain is just to the right of my heel bone. It's been several days now and it's not getting any better or any worse. It only hurts if I straighten my leg and flex my foot at the same time. The pain is also worse the higher up I lift my leg from the ground.


Answer :

Dear Patient: 
Achilles tendonitis is an inflammation of the heel tendon, usually resulting from overuse associated with a change in playing surface, footwear, extreme stretching or intensity of an activity. Sometimes called the heel cord, it is the largest tendon in the human body. When the calf muscles contract, the Achilles tendon is tightened, pulling the heel. This allows you to point your foot and stand on tiptoe. The Achilles tendon can grow weak and thin with age and lack of use. Then it becomes prone to injury or rupture. Certain illnesses (such as arthritis and diabetes) and medications (such as corticosteroids and some antibiotics) can also increase the risk of rupture. Injury can happen in these situations: You make a forceful push-off with your foot while your knee is straightened by the powerful thigh muscles. You suddenly trip or stumble, and your foot is thrust in front to break a fall, forcefully overstretching the tendon or as in your case a forceful stretching of the calf muscles. Treatment must reflect a balance between protection and early motion: Protection is necessary to allow time for healing and to prevent reinjury. Moving your foot and ankle is needed to prevent stiffness and loss of muscle tone. Consultation with an orthopedic surgeon will determine the treatment and follow-up that is right for you.


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