What Is the Achilles Tendon?
It is a band of tissue at the back of the leg which connects the calf muscle to the heel. It helps the heel raise the foot of the ground.
Achilles Tendonitis and Achilles Tendonosis
Two common disorders that occur in the heel cord are Achilles tendonitis and Achilles tendonosis.
Achilles tendonitis is an inflammation of the Achilles tendon. It usually lasts only a short time. Usually it settles on its own. However, sometimes it persists for a long time and can cause degeneration of the tendon which is then called Tendinosis.
As “overuse” disorders, Achilles tendonitis and tendinosis are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon. Due to overstress on the tendon the body is unable to repair the tendon and it can undergo degeneration and if doesn’t settle fan cause rupture of the tendon.
Athletes and labourers and people with similar work situation are at high risk since the Achilles tendon cannot recover.
Flat arch feet people are also at high risk due to different weight the foot bears and uneven distribution of the body weight.
The symptoms associated with Achilles tendonitis and tendonosis include:
- Pain—aching, stiffness, soreness or tenderness—within the tendon. . Pain often 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.
In diagnosing Achilles tendonitis or tendonosis, the surgeon will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon. The extent of the condition can be further assessed with x-rays or other imaging modalities.
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 overpronation 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.
When Is Surgery Needed?
If nonsurgical approaches fail to restore the tendon to its normal condition, surgery may be necessary. The foot and ankle surgeon will select the best procedure to repair the tendon, based on the extent of the injury, the patient’s age and activity level, and other factors.
To prevent Achilles tendonitis or tendonosis from recurring after surgical or nonsurgical treatment, the foot and ankle surgeon may recommend strengthening and stretching of the calf muscles through daily exercises. Wearing proper shoes for the foot type and activity is also important in preventing recurrence of the condition.