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Achilles tendinitis

Definition


Disease: Achilles tendinitis Achilles tendinitis
Category: Bones, joints, muscles diseases
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Disease Definition:

When the Achilles tendon becomes inflamed or irritated, Achilles tendinitis occurs. Usually sports that put a lot of pressure on the calf muscles and Achilles tendon cause this condition, such as basketball and tennis. Additionally, a sudden increase in the intensity or frequency of exercise may also end up causing Achilles tendinitis.

Achilles tendinitis is often short-lived when it's treated immediately, but if left untreated, it can cause persistent pain, or it can cause the tendon to rupture (tear). In the case of a rupture, surgery may be needed.

Rest and over-the-counter medications to reduce the pain and inflammation may be all the treatment needed for Achilles tendinitis.
 

Work Group:


Prepared by: Scientific Section

Symptoms, Causes

Symptoms:

Achilles tendinitis' signs and symptoms often develop gradually and may include:
 

  • A creaking of crackling sound when the Achilles tendon is touched or moved
  • Feeling a dull ache or pain when rising on the toes or pushing the foot off while walking
  • Feeling a "bump" or a mild swelling on the tendon
  • Tenderness over the Achilles tendon
  • Stiffness, which lessens as the tendon warms up


After resting, or after waking up in the morning, a person may feel soreness in the affected tendon that improves slightly when moving around, but then worsens again once the level of activity is increased.

In case a person experiences a sudden pain and swelling near the heel and is unable to bend his/her foot downward or walk normally, this may mean that the Achilles tendon has ruptured.
 

Causes:

Achilles tendon is also called the heel cord. It is the large band of tissues that connects the muscles in the back of the calf to the heel bone, and is used while walking, running, jumping or pushing up on the toes. When a large amount of stress is placed on the Achilles tendon too quickly, it becomes inflamed from tiny tears that occur during the activity. The cause of this is a sudden increase in a repetitive activity that involves the Achilles tendon. Some of the other factors that cause Achilles tendinitis are:

Overuse:
When starting a new exercise regimen, Achilles tendinitis can occur due to overuse. When beginning a new exercise program, the body should be properly stretched before and after the exercise. The activity should start slowly and then increase over time, for instance, excessive hill running can contribute to Achilles tendinitis.

Unsuitable conditioning:
Among athletes, who don't have suitably conditioned bodies for their sport or activity, Achilles tendinitis is quite common. Too much stress may be placed on the tendon due to insufficient flexibility and strength of the calf muscles. Activities that require repeated jumping, such as basketball or tennis, in addition to frequent stops and starts during the activity can increase the risk of Achilles tendinitis.

Infection or trauma:
In some cases, trauma or infection near the tendon can lead to inflammation of the Achilles tendon.

Flattened arch:
Having excessive pronation or flattening of the arch of the foot causes extra pressure to be put on the Achilles tendon while walking, increasing the risk of developing Achilles tendinitis. In order to avoid further aggravation of the Achilles tendon, a person with excessive pronation should wear shoes with appropriate support.
 

Complications

Complications:

None

Treatments:

There are surgical as well as non-surgical treatments for Achilles tendon ruptures.

Surgery:
In the case of having a complete rupture of the Achilles tendon, surgical treatment is quite common. In this procedure, the torn tendon is stitched together through an incision that is made in the back of the lower leg. The repair may be reinforced with other tendons, depending on the condition of the torn tissue. After the surgery, the leg will be placed in a cast, brace, boot or splint from six to eight weeks. Initially, the foot will be placed in a position pointing slightly downward in the brace or cast, in order to promote healing and avoid stretching the surgical repair. After some time, the foot will be gradually moved to a neutral position.

Generally, surgery is very effective, and the risk of complications is typically quite low, and it's preferable for people who are very active and want to resume recreational activities or strenuous sports. However, if a person is less active, or has a chronic illness, choosing a non-surgical treatment may be better, avoiding exposure to anesthesia and wound complications.

Non-surgical treatment:
This method can be quite effective, avoiding infection risks associated with surgery. To allow the ends of the torn tendon to reattach themselves on their own, a person may wear a walking boot or cast. However, recovery can take longer, and the risk of re-rupturing the tendon is higher than that of the surgical approach. Anyhow, surgical repair may be more difficult in case of re-rupturing the tendon.

In order to strengthen the leg muscles and Achilles tendon after surgical or non-surgical treatment, a person may perform physical therapy exercises. In most cases, four to six months are enough for people with a ruptured tendon to return to their former level of activity. The time and extent of recovery will depend on a person's commitment, in addition to the quality of the rehab program.
 

Prognosis:

Not available

Expert's opinion

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