Achilles Tendon Disorders

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What is the Achilles Tendon?

The Achilles tendon is a band of tissue that runs down the back of the lower leg, linking the calf muscle to the heel bone, and is where Achilles’ tendon problems arise. The Achilles tendon, often known as the heel cord, aids walking by raising the heel off the ground.

Tendonitis and tendinosis of the Achilles tendon
Achilles tendonitis and Achilles tendonosis are two prevalent ailments of the heel chord.

Achilles tendonitis is a condition in which the Achilles tendon becomes inflamed. This irritation is usually just temporary. If the problem is not addressed, it can lead to tendon degeneration (Achilles tendonosis), in which the tendon loses its structured structure and is more susceptible to produce microscopic tears.

The region where the Achilles tendon joins to the heel bone is sometimes affected by degeneration. Chronic deterioration with or without pain can lead to tendon rupture in rare circumstances.

Achilles Tendon Disorders: What Causes Them?
Achilles tendonitis and tendonosis are “overuse” illnesses that are induced by a sudden increase in a repetitive activity involving the Achilles tendon. Such exercise causes an excessive amount of stress on the tendon in a short period of time, causing micro-injury to the tendon fibers. The body is unable to repair the wounded tissue as a result of the continued tension on the tendon. The tendon’s structure is then altered, resulting in ongoing pain.

Athletes are at a higher risk of getting Achilles tendon diseases. Individuals whose occupation puts stress on their ankles and feet, such as laborers, as well as “weekend warriors”—those who are less conditioned and participate in athletics only on weekends or infrequently—are at risk for Achilles tendonitis and tendonosis.

Furthermore, people who overpronate (flatten the arch) are more likely to develop Achilles tendonitis and tendonosis due to the increased demands placed on the tendon when walking. If these people wear shoes with insufficient stability, their overpronation may aggravate the Achilles tendon even more.

Achilles Tendon Disorders Symptoms
Symptoms of Achilles tendonitis and tendonosis include:
• Within the tendon, there is pain—aching, stiffness, soreness, or tenderness. This can happen anywhere along the tendon’s path, from the attachment directly above the heel to the region just below the calf muscle. Pain frequently appears upon waking up in the morning or after periods of rest, improves slightly with motion, and then worsens with increased activity.
• When the sides of the tendon are squeezed, there is tenderness or, in some cases, intense pain. When pressing directly on the back of the tendon, however, there is less tenderness.
• When the disorder progresses to degeneration, the tendon may enlarge and nodules may form in the area where the tissue is damaged.

Achilles Tendon Disorders Diagnosis

The surgeon will examine the patient’s foot and ankle and evaluate the range of motion and condition of the tendon to diagnose Achilles tendonitis or tendonosis. X-rays or other imaging modalities can be used to determine the severity of the condition.

Achilles Tendon Disorders Treatment

Treatment approaches for Achilles tendonitis or tendonosis are chosen based on how long the injury has been present and the extent of tendon damage. When there is sudden (acute) inflammation in the early stages, one or more of the following options may be recommended:
Immobilization – To reduce forces through the Achilles tendon and promote healing, immobilization may include the use of a cast or removable walking boot.
Ice – Apply a bag of ice wrapped in a thin towel to the affected area for 20 minutes every waking hour to reduce swelling caused by inflammation. Do not apply ice directly to the skin.
Medications taken orally – In the early stages of the condition, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may be helpful in reducing pain and inflammation.
Orthotics – Custom orthotic devices may be prescribed for those with overpronation or gait abnormalities.

Splints for the night – Night splints help to keep the Achilles tendon stretched while sleeping.
Physical therapy is a type of treatment. Strengthening exercises, soft-tissue massage/mobilization, gait, and running re-education, stretching, and ultrasound therapy are all examples of physical therapy.

When Is Surgery Necessary?

If nonsurgical methods fail to restore the tendon to its normal state, surgery may be required. Based on the extent of the injury, the patient’s age and activity level, and other factors, the foot and ankle surgeon will choose the best procedure to repair the tendon.

Prevention

The foot and ankle surgeon may recommend daily calf muscle strengthening and stretching exercises to prevent the recurrence of Achilles tendonitis or tendonosis after surgical or nonsurgical treatment. Wearing appropriate shoes for the foot type and activity is also important in preventing the condition from recurring.

Why should you go with a foot and ankle surgeon?

Foot and ankle surgeons are the foremost authorities on foot and ankle care today. Doctors of podiatric medicine – also known as podiatrists, DPMs, or “foot and ankle doctors” – are the podiatric profession’s board-certified surgical specialists. Foot and ankle surgeons have more specialized education and training than any other type of healthcare provider.

Foot and ankle surgeons treat all foot and ankle conditions, from simple to complex, in patients of all ages, including Achilles tendon disorders. Foot and ankle surgeons are qualified to perform a wide range of surgeries, including any surgery that may be indicated for Achilles tendon disorders, due to their extensive education and training.

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