The Achilles tendon attaches the calf muscle to the heel bone. Achilles tendonitis is a repetitive strain (overuse) injury involving lower leg muscles and tendons at the point
where they attach to the bone, resulting in pain at the back of the ankle. Chronic overuse can lead to small tears within the tendon causing long-term weakening, making the tendon susceptible to
rupture, which could result in a need for surgery.
Hill running or stair climbing. Overuse resulting from the natural lack of flexibility in the calf muscles. Rapidly increasing mileage or speed. Starting up too quickly after a layoff. Trauma caused
by sudden and hard contraction of the calf muscles when putting out extra effort such as in a final sprint. Achilles tendinitis often begins with mild pain after exercise or running that gradually
The symptoms associated with Achilles tendonitis and tendonosis include, Pain-aching, stiffness, soreness, or tenderness-within the tendon. This may occur anywhere along the tendon?s path, beginning
with the tendon?s attachment directly above the heel upward to the region just below the calf muscle. Often pain appears upon arising in the morning or after periods of rest, then improves somewhat
with motion but later worsens with increased activity. Tenderness, or sometimes intense pain, when the sides of the tendon are squeezed. There is less tenderness, however, when pressing directly on
the back of the tendon. When the disorder progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged.
The doctor will perform a physical exam. The doctor will look for tenderness along the tendon and pain in the area of the tendon when you stand on your toes. X-rays can help diagnose bone problems.
An MRI scan may be done if your doctor is thinking about surgery or is worried about the tear in the Achilles tendon.
Treatment approaches for Achilles tendonitis or tendonosis are selected on the basis of how long the injury has been present and the degree of damage to the tendon. In the early stage, when there is
sudden (acute) inflammation, one or more of the following options may be recommended. Immobilization. Immobilization may involve the use of a cast or removable walking boot to reduce forces through
the Achilles tendon and promote healing. Ice. To reduce swelling due to inflammation, apply a bag of ice over a thin towel to the affected area for 20 minutes of each waking hour. Do not put ice
directly against the skin. Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation in the early stage of the
condition. Orthotics. For those with over-pronation or gait abnormalities, custom orthotic devices may be prescribed. Night splints. Night splints help to maintain a stretch in the Achilles tendon
during sleep. Physical therapy. Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait and running re-education, stretching, and ultrasound therapy.
There are three common procedures that doctor preform in order help heal the tendinitis depending on the location of the tendinitis and amount of damage to the tendon, including: Gastrocnemius
recession - With this surgery doctors lengthen the calf muscles because the tight muscles increases stress on the Achilles tendon. The procedure is typically done on people who have difficulty
flexing their feet even with constant stretching. Debridement and Repair - When there is less than 50% damage in the tendon, it is possible for doctors to remove the injured parts and repair the
healthy portions. This surgery is most done for patients who are suffering from bone spurs or arthritis. To repair the tendon doctors may use metal or plastic anchors to help hold the Achilles tendon
in place. Patients have to wear a boot or cast for 2 weeks or more, depending and the damage done to the tendon. Debridement with Tendon Transfer - When there is more the 50% damage done to the
Achilles tendon, and Achilles tendon transfer is preformed because the remain healthy tissue is not strong enough. The tendon that helps the big toe move is attached to give added strength to the
damaged Achilles. After surgery, most patients don?t notice any difference when they walk or run.
Appropriately warm up and stretch before practice or competition. Allow time for adequate rest and recovery between practices and competition. Maintain appropriate conditioning, Ankle and leg
flexibility, Muscle strength and endurance, Cardiovascular fitness. Use proper technique. To help prevent recurrence, taping, protective strapping, or an adhesive bandage may be recommended for
several weeks after healing is complete.