You?re a prime candidate for acquiring Achilles Tendonitis if you?re a runner or some other kind of athlete requiring heavy use of your calves and their attached tendons. Then
again, -anybody- can get tendonitis of the Achilles tendons. All for very predictable reasons. Perhaps you have Achilles Tendon pain from cycling. Or standing at work. Or walking around a lot.
Anything we do on our feet uses our lower leg structures, and the Achilles tendon bears LOTS of torque, force, load, etc. The physical dynamic called Tendonitis can show up anywhere. On the Achilles
Tendon is as good a place as any. Repetitive strain injury can show up anywhere in the body that there is repetitive strain. It's an obvious statement, but worth paying attention to.
Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to happen suddenly, but
usually it is the result of many tiny tears to the tendon that have happened over time. Health professionals may use different terms to describe a tendon injury. You may hear, Tendonitis (or
Tendinitis): This actually means "inflammation of the tendon," but inflammation is rarely the cause of your tendon pain.
Symptoms of Achilles Tendinitis include the following. Pain and stiffness along the Achilles tendon in the morning. Pain along the tendon or back of the heel that worsens with activity. Severe pain
the day after exercising. Thickening of the tendon. Bone spur (insertional tendinitis). Swelling that is present all the time and gets worse throughout the day with activity. If you have an Achilles
tendon rupture, you might feel a pop or snap, accompanied by a sharp pain behind your ankle. You are likely to have difficulty walking properly. If you have ruptured your Achilles tendon then surgery
is likely to be the best treatment option.
Laboratory studies usually are not necessary in evaluating and diagnosing an Achilles tendon rupture or injury, although evaluation may help to rule out some of the other possibilities in the
differential diagnosis. Imaging studies. Plain radiography: Radiographs are more useful for ruling out other injuries than for ruling in Achilles tendon ruptures. Ultrasonography: Ultrasonography of
the leg and thigh can help to evaluate the possibility of deep venous thrombosis and also can be used to rule out a Baker cyst; in experienced hands, ultrasonography can identify a ruptured Achilles
tendon or the signs of tendinosis. Magnetic resonance imaging (MRI): MRI can facilitate definitive diagnosis of a disrupted tendon and can be used to distinguish between paratenonitis, tendinosis,
Conservative management of Achilles tendinosis and paratenonitis includes the following. Physical therapy. Eccentric exercises are the cornerstone of strengthening treatment, with most patients
achieving 60-90% pain relief. Orthotic therapy in Achilles tendinosis consists of the use of heel lifts. Nonsteroidal anti-inflammatory drugs (NSAIDs): Tendinosis tends to be less responsive than
paratenonitis to NSAIDs. Steroid injections. Although these provide short-term relief of painful symptoms, there is concern that they can weaken the tendon, leading to rupture. Vessel sclerosis.
Platelet-rich plasma injections. Nitric oxide. Shock-wave therapy. Surgery may also be used in the treatment of Achilles tendinosis and paratenonitis. In paratenonitis, fibrotic adhesions and nodules
are excised, freeing up the tendon. Longitudinal tenotomies may be performed to decompress the tendon. Satisfactory results have been obtained in 75-100% of cases. In tendinosis, in addition to the
above procedures, the degenerated portions of the tendon and any osteophytes are excised. Haglund?s deformity, if present, is removed. If the remaining tendon is too thin and weak, the plantaris or
flexor hallucis longus tendon can be weaved through the Achilles tendon to provide more strength. The outcome is generally less favorable than it is in paratenonitis surgery.
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.
There are several things you can do to reduce the risk of Achilles tendinitis, warm up every time before you exercise or play a sport. Switch up your exercises. Slowly increase the length and
intensity of your workouts. Keep your muscles active and stay in shape all year-round. When you see symptoms of Achilles tendinitis, stop whatever activity you are doing and rest.