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Achilles Tendon Disorders

Achilles tendon disorders are conditions that affect the Achilles tendon, typically caused by overuse or sudden injuries. Common disorders include insertional tendonitis, non insertional tendonitis and Achilles tendon rupture. Athletes or people who overstress their ankles and feet are at high risk of developing disorders of the Achilles tendon.

What is the Achilles Tendon?

The Achilles tendon is the largest tendon in the body. It connects the calf muscle to the heel bone and is a component in normal walking, climbing stairs, running, and jumping. The Achilles tendon can withstand great stresses, but is prone to tendonitis which can occur with overuse and degeneration.

Achilles Tendonitis

Defined as inflammation of a tendon. Inflammation is the body’s natural response to injury or disease and can cause swelling, pain, or irritation.

Two Types of Tendonitis

Two common types of Achilles Tendonitis are non insertional tendonitis and insertional tendonitis.

Non insertional tendonitis (above the heel bone)

Tendon fibers in the middle portion of the tendon break down with tiny tears (degenerate), swell, and thicken. This type of tendonitis more commonly affects younger, active patients.

Insertional tendonitis (at the heel bone)

Involves the lower portion of the tendon, at the heel bone where the tendon attaches (inserts). Damaged tendon fibers may calcify (harden). Bone spurs (extra bone growth) often form with this type of Achilles tendonitis. This type of tendonitis can occur at any time, even in patients that are not active. However, this can also come from years of overuse (runners, sprinters).

What Causes Tendonitis?

No specific injury is required for tendonitis to occur. The problem typically results from repeated stress to the tendon. These are some associated factors:

  • Sudden increase in amount or intensity of exercise or activity
  • Tight calf muscles
  • Bone spur at the heel

Symptoms of Achilles Tendonitis

  • Pain and stiffness along the Achilles tendon in the morning
  • Pain at the tendon or back of heel that is worse with activity or contact with shoes
  • Pain the day after exercise
  • Thickening of the tendon
  • Bone spur
  • Swelling that is present constantly, worse throughout the day with activity
    If you experience a sudden “pop” or feel like you have ruptured your Achilles tendon you should see your doctor immediately.

Diagnosis and Treatment for Achilles Tendonitis

Imaging tests may be used to help confirm Achilles tendonitis, including:

X-ray: Gives an image of the bones. Can show if there is calcification within the tendon itself, at the insertion of the tendon, and if there is a bone spur present.

MRI: Gives an image of the bones, tendon, ligaments, and other soft tissues. Not required for the diagnosis of Achilles tendonitis, but may be beneficial for surgical planning if you and your doctor are considering this as a treatment option.

Treatment for Achilles tendonitis is selected depending on the severity of the damage to the tendon. Surgery may be advised if non-surgical methods fail to restore the tendon.

Non-surgical treatment provides pain relief in most cases, but may take several months for symptoms to completely subside. Patients with symptoms for longer than 3 months may take several months for treatment methods to take effect.

  • Rest. Decreasing or stopping activities that make your symptoms worse. Switching from high-impact activity (running, jumping) to low impact activity (bicycle, swimming) will put less stress on the Achilles tendon.
  • Ice. Placing ice on the most painful area (never directly contact ice with skin) can be helpful throughout the day. Can be done for up to 20 minutes and should be stopped if skin becomes numb.
  • Non-steroidal anti-inflammatory medication. Short-term use of drugs such as Ibuprofen/naproxen can be helpful to reduce pain and swelling.
  • Exercise/Physical therapy. Calf stretching in addition to physical therapy have been shown to be effective methods for treatment of insertional and non-insertional Achilles tendonitis
  • Cortisone injection. Not recommended as they can cause tendon rupture (tear)
  • Supportive shoes/orthotics. Pain from insertional Achilles tendonitis can be relieved by shoes with soft heel cups can reduce irritation. Heel lifts can also help take some strain off of the tendon. If pain is severe, a walking boot may be recommended for a short period of time to reduce inflammation.

Surgical treatment should be considered if pain does not improve after 6 months of nonsurgical treatment. The type of surgery depends on the amount of damage to the tendon. Specific surgical treatment should be tailored to your specific condition and discussed with your doctor.

Achilles Tendon Rupture

This injury is characterized by the complete tearing of the tendon fibers which leads the tendon unable to perform its normal function. Most tendon ruptures occur within the tendon itself, above the heel bone. The most commonly affected are between the ages of 30 – 50 years old, with most occurring while performing sporting activity.

Symptoms of Achilles Tendon Rupture

Most ruptures will occur during running/jogging/landing when the tendon is abruptly pulled longer than what it is capable of. Some patients report a “pop” in the back of their leg at the time of rupture. Common symptoms include pain, swelling, and weakness after rupture. If you are concerned about Achilles tendon rupture, you should see a doctor urgently.

Treatment for Achilles Tendon Rupture

Treatment options consist of non-surgical and surgical repair. The rehabilitation process between non-surgical treatment and surgical repair are similar. Full rehabilitation from time of injury is 9-12 months and some patients can see benefits thereafter. ROC Express provides an excellent way to be evaluated promptly after injury and starting appropriate treatment immediately.

Why Choose ROC?

ROC Express provides an excellent way to be evaluated promptly after injury and starting appropriate treatment immediately. Visit any one of our walk-in locations in Reno, Sparks or Carson City, or contact us for more information.

This article was modified/summarized from the following websites: