Achilles tendonitis (tendinitis), is a painful and often debilitating inflammation of the Achilles tendon than can progress into degeneration which we call Achilles
Tendinosis. The Achilles tendon is the largest and strongest tendon in the body. It is located in the back of the lower leg, attaches to the heel bone (calcaneus), and connects the calf muscles to
the heel bone. In most cases, Achilles tendonopathy's are overuse injuries are more common among athletes and people who train heavily, however it can also occur in people who are less active.
Achilles Tendonitis can vary in severity from a mild pain in the tendon during a particular activity to more severe cases when any form of activity that puts strain on this ligament, even standing or
walking, can cause pain.
Achilles tendonitis is a common sports injury caused by repeated or intense strain on the tendon. But non-athletes also can get it if they put a lot of stress on their feet. Other things that
contribute to Achilles tendonitis include. An increase in activity. Starting a training program after a period of inactivity or adding miles or hills to a jogging regimen are two examples of things
that put people at risk for Achilles tendonitis. Sports that require sudden starts and stops; for example, tennis and basketball. A change in footwear, or wearing old or badly fitting shoes. New
shoes, worn-out shoes, or the wrong size shoes can cause a person's feet to overcompensate and put stress on the Achilles tendon. Additionally, wearing high heels all the time can cause the tendon
and calf muscles to get shorter, and the switch to flat shoes and exercise can put extra strain on the heel. Running up hills. Going uphill forces the Achilles tendon to stretch beyond its normal
range. Weak calf muscles, flat arches, "overpronation" (feet that roll in when running), or "oversupination" (feet that roll out when running). Overpronation and oversupination make the lower leg
rotate and put a twisting stress on the tendon. Exercising without warming up. Tight calf muscles or muscles that lack flexibility decrease a person's range of motion and put an extra strain on the
tendon. Running or exercising on a hard or uneven surface or doing lunges or plyometrics without adequate training. A traumatic injury to the Achilles tendon.
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.
During an examination of the foot and ankle, you doctor will look for the following signs, Achilles tendon swelling or thickening. Bone spurs appearing at the lower part of the tendon at the back of
the hell. Pain at the middle or lower area of the Achilles tendon. Limited range of motion of the foot and ankle, and a decreased ability to flex the foot. Your doctor may perform imaging tests, such
as X-rays and MRI scans, to make a diagnosis of Achilles tendinitis. X-rays show images of the bones and can help the physician to determine if the Achilles tendon has become hardened, which
indicated insertional Achilles tendinitis. MRI scans may not be necessary, but they are important guides if you are recommended to have surgical treatment. An MRI can show the severity of the damage
and determine what kind of procedure would be best to address the condition.
Most cases are successfully treated non-surgically although this is time-consuming and frustrating for active patients. Treatment is less likely to be successful if symptoms have been present more
than six months. Nonsurgical management includes nonsteroidal anti-inflammatory medications, rest, immobilization, limitation of activity, ice, contrast baths, stretching and heel lifts. If symptoms
fail to resolve after two to three months, a formal physical therapy program may be of benefit. An arch support may help if there is an associated flatfoot. A cast or brace to completely rest this
area may be necessary. Extracorporeal shockwave therapy and platelet-rich plasma injections? have variable reports of success. Nitroglycerin medication applied to the overlying skin may be of
Histological and biological studies on tendon healing have made it possible to envisage surgical repair using a percutaneous approach, with the following objectives, a minimal, and not very
aggressive, operation, which is quick and easy and within the capabilities of all surgeons, the shortest hospitalisation period possible, above all, early and effective re-education, providing a
satisfactory result both in terms of solidity and the comfort of the patient. The percutaneous tenosynthesis TENOLIG combines stability, reliability, patient comfort and lower overall social and
professional costs for this type of lesion.
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.