is an irritation/inflammation in the achilles tendon, which attaches to the back of the heel. It is often a result of overuse and occurs frequently in runners who have altered their training
suddenly, either with regard to duration or intensity. This injury is also prevalent in middle-aged people who are active.
Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon, but
other factors can make it more likely to develop tendinitis, including a bone spur that has developed where the tendon attaches to the heel bone, Sudden increase in the amount or intensity of
exercise activity-for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance, Tight calf muscles, Having tight calf muscles
and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon, Bone spur-Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the
tendon and cause pain.
Patients with an Achilles tendon rupture frequently present with complaints of a sudden snap in the lower calf associated with acute, severe pain. The patient reports feeling like he or she has been
shot, kicked, or cut in the back of the leg, which may result in an inability to ambulate further. A patient with Achilles tendon rupture will be unable to stand on his or her toes on the affected
side. Tendinosis is often pain free. Typically, the only sign of the condition may be a palpable intratendinous nodule that accompanies the tendon as the ankle is placed through its range of motion
(ROM). Patients with paratenonitis typically present with warmth, swelling, and diffuse tenderness localized 2-6 cm proximal to the tendon's insertion. Paratenonitis with tendinosis. This is
diagnosed in patients with activity-related pain, as well as swelling of the tendon sheath and tendon nodularity.
During an examination of the foot and ankle, you doctor will look for the following signs, Achilles tendon swelling or thickening. Bone spurs appearing at the lower part of the tendon at the back of
the hell. Pain at the middle or lower area of the Achilles tendon. Limited range of motion of the foot and ankle, and a decreased ability to flex the foot. Your doctor may perform imaging tests, such
as X-rays and MRI scans, to make a diagnosis of Achilles tendinitis. X-rays show images of the bones and can help the physician to determine if the Achilles tendon has become hardened, which
indicated insertional Achilles tendinitis. MRI scans may not be necessary, but they are important guides if you are recommended to have surgical treatment. An MRI can show the severity of the damage
and determine what kind of procedure would be best to address the condition.
Treatment for Achilles tendonitis, depends on the severity of the injury. If heel pain, tenderness, swelling, or discomfort in the back of the lower leg occurs, physical activity that produces the
symptoms should be discontinued. If the problem returns or persists, a medical professional should be consulted. If pain develops even with proper stretching and training techniques, the patient
should consult a podiatrist to check for hyperpronation and adequate arch support. The addition of an orthotic may be enough to maintain good arch and foot alignment and eliminate pain. If damage to
the tendon is minor, the injury may respond to a simple course of treatment known as RICE (rest, ice, compression, elevation). Patients are advised to rest the tendon by keeping off their feet as
much as possible, apply ice packs for 20 minutes at a time every hour for a day or two to reduce swelling, compress the ankle and foot with a firmly (not tightly) wrapped elastic bandage and elevate
the foot whenever possible to minimize swelling. A nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen may be used to reduce pain, swelling, and inflammation.
If non-surgical treatment fails to cure the condition then surgery can be considered. This is more likely to be the case if the pain has been present for six months or more. The nature of the surgery
depends if you have insertional, or non-insertional disease. In non-insertional tendonosis the damaged tendon is thinned and cleaned. The damage is then repaired. If there is extensive damage one of
the tendons which moves your big toe (the flexor hallucis longus) may be used to reinforce the damaged Achilles tendon. In insertional tendonosis there is often rubbing of the tendon by a prominent
part of the heel bone. This bone is removed. In removing the bone the attachment of the tendon to the bone may be weakened. In these cases the attachment of the tendon to the bone may need to be
reinforced with sutures and bone anchors.
Maintaining strength and flexibility in the muscles of the calf will help reduce the risk of tendinitis. Overusing a weak or tight Achilles tendon makes you more likely to develop tendinitis.