Achilles tendinitis is inflammation of the Achilles tendon, the fibrous tissue that connects the heel to the calf muscles. This condition is often caused by irritation of the tendon and typically affects those who play sports. However, older individuals who suffer from arthritis may also be affected. Achilles tendinitis is typically the first stage of an Achilles tendon injury and should be treated right away. Without treatment, the tendon can tear or rupture, which may require surgery.
There are two large muscles in the calf. These muscles are important for walking. They create the power needed to push off with the foot or go up on the toes. The large Achilles tendon connects these muscles to the heel. Heel pain is most often due to overuse of the foot. Rarely it is caused by an injury. Tendinitis due to overuse is most common in younger people. It can occur in walkers, runners, or other athletes. Achilles tendinitis may be more likely to occur if you Suddenly increase the amount or intensity of an activity. Your calf muscles are very tight (not stretched out). You run on hard surfaces such as concrete. You run too often, you jump a lot (such as when playing basketball), you do not have shoes with proper support, your foot pain from running (kaitlinroeser.wordpress.com) suddenly turns in or out. Tendinitis from arthritis is more common in middle-aged and elderly people. A bone spur or growth may form in the back of the heel bone. This may irritate the Achilles tendon and cause pain and swelling.
Patients with an Achilles tendon rupture frequently present with complaints of a sudden snap in the lower calf associated with acute, severe pain. The patient reports feeling like he or she has been shot, kicked, or cut in the back of the leg, which may result in an inability to ambulate further. A patient with Achilles tendon rupture will be unable to stand on his or her toes on the affected side. Tendinosis is often pain free. Typically, the only sign of the condition may be a palpable intratendinous nodule that accompanies the tendon as the ankle is placed through its range of motion (ROM). Patients with paratenonitis typically present with warmth, swelling, and diffuse tenderness localized 2-6 cm proximal to the tendon's insertion. Paratenonitis with tendinosis. This is diagnosed in patients with activity-related pain, as well as swelling of the tendon sheath and tendon nodularity.
X-rays are usually normal in patients with Achilles tendonitis, but are performed to evaluate for other possible conditions. Occasionally, an MRI is needed to evaluate a patient for tears within the tendon. If there is a thought of surgical treatment an MRI may be helpful for preoperative evaluation and planning.
Many physical therapies exist to help with the pain. We have found the combination of modalities, stretching, acupuncture, footwear modification and myofascial release to be very effective. In resilient cases, a promising new treatment called Radial Shockwave may be indicated. The key to the treatment of this, and other foot problems, is an accurate diagnosis. With this, a treatment regimen tailored to you and your specific situation can be devised. We treat many acute and chronic achilles tendinitis in Edmonton and St. Albert, so remember ?it shouldn?t hurt.?
Surgery is an option of last resort. However, if friction between the tendon and its covering sheath makes the sheath thick and fibrous, surgery to remove the fibrous tissue and repair any tears may be the best treatment option.
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.
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