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Welcome to Orthopaedic Solutions & Sports Medicine Center, PA

Achilles Tendinitis

Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon. A bone spur that has developed where the tendon attaches to the heel bone.

  • Sudden increase in the amount or intensity of exercise activity—for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance

  • Tight calf muscles—Having tight calf muscles and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon

  • Bone spur—Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain

Symptoms

Common symptoms of Achilles tendinitis include:

  • Pain and stiffness along the Achilles tendon in the morning

  • Pain along the tendon or back of the heel that worsens with activity

  • Severe pain the day after exercising

  • Thickening of the tendon

  • Bone spur (insertional tendinitis)

  • Swelling that is present all the time and gets worse throughout the day with activity

If you have experienced a sudden "pop" in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See Dr. Parikh and his team immediately if you think you may have torn your tendon

Treatment

Nonsurgical

In most cases, nonsurgical treatment options will provide pain relief, although it may take a few months for symptoms to completely subside. Even with early treatment, the pain may last longer than 3 months

Rest. The first step in reducing pain is to decrease or even stop the activities that make the pain worse.

Ice. Placing ice on the most painful area of the Achilles tendon is helpful and can be done as needed throughout the day.

Non-steroidal anti-inflammatory medication. Drugs such as ibuprofen and naproxen reduce pain and swelling.

Exercise. exercise can help to strengthen the calf muscles and reduce stress on the Achilles tendon.

Physical Therapy. Physical therapy is very helpful in treating Achilles tendinitis.

Cortisone injections. Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections into the Achilles. Supportive shoes and orthotics. Pain from insertional Achilles tendinitis is often helped by certain shoes, as well as orthotic devices

If your pain is severe, Dr. Parikh and his team may recommend a walking boot for a short time. This gives the tendon a chance to rest before any therapy is begun. Extended use of a boot is discouraged, though, because it can weaken your calf muscle.

Surgical

Surgery should be considered to relieve Achilles tendinitis only if the pain does not improve after 6 months of nonsurgical treatment. Débridement and repair (tendon has less than 50% damage). The goal of this operation is to remove the damaged part of the Achilles tendon. Once the unhealthy portion of the tendon has been removed, the remaining tendon is repaired with sutures, or stitches to complete the repair.

After débridement and repair, most patients are allowed to walk in a removable boot or cast within 2 weeks, although this period depends upon the amount of damage to the tendon.

Recovery. Most patients have good results from surgery. The main factor in surgical recovery is the amount of damage to the tendon. The greater the amount of tendon involved, the longer the recovery period.

Physical therapy is an important part of recovery. Many patients require 12 months of rehabilitation before they are pain-free.


Information obtain from www.orthoinfo.aaos.org

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