Achilles tendonitis is a
condition wherein the Achilles tendon, at or near its insertion to back of the heel, becomes inflamed and causes pain. The Achilles tendon is one of the longest and strongest tendons in the body. It
is avascular (not supplied with blood vessels) so it can be slow to heal. The Achilles tendon is formed in the lower third of the leg. Two muscles join to form the Achilles tendon, the Gastrocnemius
and the Soleus which are commonly referred to as the calf muscle. The Achilles tendon works as an anti-pronator which means it helps to prevent the foot from rolling inward.
As ?overuse? disorders, Achilles tendonitis and tendonosis are usually caused by a sudden increase of a repetitive activity involving the Achilles tendon. Such activity puts too much stress on the
tendon too quickly, leading to micro-injury of the tendon fibers. Due to this ongoing stress on the tendon, the body is unable to repair the injured tissue. The structure of the tendon is then
altered, resulting in continued pain. Achilles4Athletes are at high risk for developing disorders of the Achilles tendon. Achilles tendonitis and tendonosis are also common in individuals whose work
puts stress on their ankles and feet, such as laborers, as well as in ?weekend warriors?-those who are less conditioned and participate in athletics only on weekends or infrequently. In addition,
people with excessive pronation (flattening of the arch) have a tendency to develop Achilles tendonitis and tendonosis due to the greater demands placed on the tendon when walking. If these
individuals wear shoes without adequate stability, their over-pronation could further aggravate 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.
On examination, an inflamed or partially torn Achilles tendon is tender when squeezed between the fingers. Complete tears are differentiated by sudden, severe pain and inability to walk on the
extremity. A palpable defect along the course of the tendon. A positive Thompson test (while the patient lies prone on the examination table, the examiner squeezes the calf muscle; this maneuver by
the examiner does not cause the normally expected plantar flexion of the foot).
Your podiatrist may recommend one or more of these treatments to manage your pain. A bandage specifically designed to restrict motion of the tendon. Over the counter, non-steroidal anti-inflammatory
medication (ibuprofen). Custom orthotic shoe inserts to relieve stress on the tendon. Rest. Switching to a low impact exercise such as swimming, that does not stress the tendon. Stretching, massage,
ultrasound and appropriate exercises to strengthen the muscles that support the achilles tendon. In extreme cases, surgery is necessary to remove the damaged tissue and repair any tears.
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.
The following measures can significantly reduce the risk of developing Achilles tendonitis. Adequately stretch and warm up prior to exercise. Warm down and stretch after exercise. Choose footwear
carefully and use footwear appropriate to the sport being undertaken. Use orthotic devices in footwear to correctly support the foot. Exercise within fitness levels and follow a sensible exercise
programme. Develop strong, flexible calf muscles.