tendonitis is a condition of irritation and inflammation of the large tendon in the back of the ankle. Achilles tendonitis is a common injury that tends to occur in recreational athletes. Overuse of
the Achilles tendon can cause inflammation that can lead to pain and swelling. Achilles tendonitis is differentiated from another common Achilles tendon condition called Achilles tendinosis. Patients
with Achilles tendinosis have chronic Achilles swelling and pain as a result of degenerative, microscopic tears within the tendon.
Although a specific incident of overstretching can cause an Achilles tendon disorder, these injuries typically result from a gradually progressive overload of the Achilles tendon or its attachment to
bone. The cause of this chronic overload is usually a combination of factors that can put excess stress on the tendon: being overweight, having a tight calf muscle, standing or walking for a long
period of time, wearing excessively stiff or flat footwear, or engaging in significant sports activity.
Achilles tendonitis may be felt as a burning pain at the beginning of activity, which gets less during activity and then worsens following activity. The tendon may feel stiff first thing in the
morning or at the beginning of exercise. Achilles tendonitis usually causes pain, stiffness, and loss of strength in the affected area. The pain may get worse when you use your Achilles tendon. You
may have more pain and stiffness during the night or when you get up in the morning. The area may be tender, red, warm, or swollen if there is inflammation. You may notice a crunchy sound or feeling
when you use the tendon.
A thorough subjective and objective examination from a physiotherapist is usually sufficient to diagnose an Achilles injury such as Achilles tendonitis. Occasionally, further investigations such as
an Ultrasound, X-ray or MRI scan may be required to assist with diagnosis and assess the severity of the condition.
The recommended treatment for Achilles tendinitis consists of icing, gentle stretching, and modifying or limiting activity. Nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen or
aspirin, can reduce pain and swelling. Physical therapy and the use of an orthotic (heel lift) can also be helpful. For chronic cases where tendinosis is evident and other methods of treatment have
failed, surgery may be recommended to remove and repair the damaged tissue.
There are three common procedures that doctor preform in order help heal the tendinitis depending on the location of the tendinitis and amount of damage to the tendon, including: Gastrocnemius
recession - With this surgery doctors lengthen the calf muscles because the tight muscles increases stress on the Achilles tendon. The procedure is typically done on people who have difficulty
flexing their feet even with constant stretching. Debridement and Repair - When there is less than 50% damage in the tendon, it is possible for doctors to remove the injured parts and repair the
healthy portions. This surgery is most done for patients who are suffering from bone spurs or arthritis. To repair the tendon doctors may use metal or plastic anchors to help hold the Achilles tendon
in place. Patients have to wear a boot or cast for 2 weeks or more, depending and the damage done to the tendon. Debridement with Tendon Transfer - When there is more the 50% damage done to the
Achilles tendon, and Achilles tendon transfer is preformed because the remain healthy tissue is not strong enough. The tendon that helps the big toe move is attached to give added strength to the
damaged Achilles. After surgery, most patients don?t notice any difference when they walk or run.
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.