Achilles tendonitis is an inflammation of
the Achilles tendon. This inflammation is typically short-lived. Over time, if not resolved, the condition may progress to a degeneration of the tendon (Achilles tendonosis), in which the tendon
loses its organized structure and is likely to develop microscopic tears. Sometimes the degeneration involves the site where the Achilles tendon attaches to the heel bone. In rare cases, chronic
degeneration with or without pain may result in rupture of the tendon.
Achilles tendinitis may be caused by intensive hill running, sprinting, or stair climbing. Overuse resulting from the natural lack of flexibility in the calf muscles. Rapidly increasing intensity of
exercise, especially after a period of inactivity. Sudden and hard contraction of the calf muscles when exerting extra effort, like that in a final sprint or high jump.
Dull or sharp pain anywhere along the back of the tendon, but usually close to the heel. limited ankle flexibility redness or heat over the painful area a nodule (a lumpy build-up of scar tissue)
that can be felt on the tendon a cracking sound (scar tissue rubbing against tendon) with ankle movement.
The diagnosis is made via discussion with your doctor and physical examination. Typically, imaging studies are not needed to make the diagnosis. However, in some cases, an ultrasound is useful in
looking for evidence of degenerative changes in the tendon and to rule out tendon rupture. An MRI can be used for similar purposes, as well. Your physician will determine whether or not further
studies are necessary.
In order to treat achilles tendinitis effectively, it is important to complete a thorough examination of the entire lower extremity. Once the true cause is identified, a comprehensive treatment
program can be initiated to reduce inflammation and improve any faulty lower extremity biomechanics. Treatment options may include biomechanical analysis of gait. Splinting/bracing to alleviate the
strain on the tendon. Soft tissue mobilization/manual therapy to decrease inflammation and promote healing of the tendon. Strengthening/flexibility and proprioceptive exercises. Home exercise
program. Modalities for pain and inflammation (i.e. ultrasound, iontophoresis, electrical stimulation, ice). Methods to alter faulty mechanics (i.e taping, orthotics). Education about lifestyle
changes (i.e. proper shoes, activity modification).
Surgery for an Achilles tendon rupture can be done with a single large incision, which is called open surgery. Or it can be done with several small incisions. This is called percutaneous surgery. The
differences in age and activity levels of people who get surgery can make it hard to know if Achilles tendon surgery is effective. The success of your surgery can depend on, your surgeon's
experience. The type of surgery you have. How damaged the tendon is. How soon after rupture the surgery is done. How soon you start your rehab program after surgery. How well you follow your rehab
program. Talk to your surgeon about his or her surgical experience. Ask about his or her success rate with the technique that would best treat your condition.
Suggestions to reduce your risk of Achilles tendonitis include, icorporate stretching into your warm-up and cool-down routines. Maintaining an adequate level of fitness for your sport. Avoid dramatic
increases in sports training. If you experience pain in your Achilles tendon, rest the area. Trying to ?work through? the pain will only make your injury worse. Wear good quality supportive shoes
appropriate to your sport. If there is foot deformity or flattening, obtain orthoses. Avoid wearing high heels on a regular basis. Maintaining your foot in a ?tiptoe? position shortens your calf
muscles and reduces the flexibility of your Achilles tendon. An inflexible Achilles tendon is more susceptible to injury. Maintain a normal healthy weight.