Common Disorders of the Achilles Tendon

The Achilles tendon is one of the strongest and thickest tendons in the human body, but it is not invincible. Common disorders of the Achilles tendon include Achilles tendonitis and Achilles tendonosis. As a band of tissue that connects the calf muscle to the heel bone, the Achilles tendon is responsible for facilitating walking by helping to raise the heel off the ground.

Achilles tendonitis is an inflammation of the Achilles tendon that is typically short-lived. However, if left untreated, it may progress to a degeneration of the tendon known as Achilles tendonosis. In this condition, the tendon loses its organized structure and is likely to develop microscopic tears. Sometimes, the degeneration may involve the site where the Achilles tendon attaches to the heel bone. In rare cases, chronic degeneration with or without pain may result in the rupture of the tendon.

Causes of these conditions are typically due to repetitive activities which puts too much stress on the tendon too quickly, leading to micro-injury of the tendon fibers. Inability to repair the injured tissue leads to the structure of the tendon becoming altered, resulting in continued pain. Common at-risk groups of individuals for these conditions time include athletes, laborers, those who are not as conditioned and participate in sports only on weekends or infrequently, and those with excessive pronation.

Symptoms of Achilles tendonitis and tendonosis include pain, stiffness, soreness, or tenderness within the tendon. This pain occurs 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, may occur when the sides of the tendon are squeezed. When the disorder progresses to degeneration, the tendon may become enlarged and may develop nodules in the area where the tissue is damaged.

If you are experiencing any of these symptoms, it is important to see a doctor for diagnosis and treatment. To diagnose Achilles tendonitis or tendonosis, a foot and ankle 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 based on 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, options such as immobilization, ice, oral medications (such as ibuprofen), custom orthotic devices, night splints, and physical therapy may be recommended. If non-surgical 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 upon 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 non-surgical 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.

In conclusion, disorders of the Achilles tendon can be both debilitating and painful. Early intervention and proper treatment are essential to ensure a successful recovery, and if left untreated, can lead to more severe health conditions. If you are experiencing any symptoms, contact your doctor or Dr. Gilbert Huang DPM to begin your journey towards recovery.

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