Achilles tendon connects the calf muscles in the lower leg to the heel bone. It is the largest yet most exposed tendon in the body. Achilles tendonitis is where the Achilles tendon, and sometimes the
protective sheath through which it moves, becomes inflamed, causing pain and swelling symptoms. Achilles tendonitis (also known as Achilles tendinopathy or tendonosis) is classified as an overuse
injury. If left untreated it can become chronic (long-term), requiring more intensive treatment. Achilles tendonitis can also increase the risk of sustaining an Achilles tendon rupture (tear).
Like any muscle or tendon in the body, the older we get, the more likely we are to sustain an injury. So middle-aged men and women are most at risk, with a slightly higher risk factor attributed to
males. Those who participate in more intense athletic activities like high impact sports (tennis, running, basketball) are most susceptible to the injury. Certain underlying medical conditions can
also be a contributing factor. Diabetics are more at risk of suffering from Achilles Tendinitis, as are those who are not in great physical shape. Some antibiotics, particularly fluoroquinolones can
make one more likely to suffer a strained Achilles Tendon.
Symptoms vary because you can injure various areas of the muscle-tendon complex. The pain may be an acute or chronic sharp, stabbing, piercing, shooting, burning or aching. It is often most
noticeable immediately after getting out of bed in the morning, or after periods of inactivity, like sitting down for lunch. After a couple minutes of walking around, it will often then settle down
somewhat, before becoming symptomatic again after excessive time standing or walking. But regardless of how the pain is perceived, Achilles tendon pain should not be left untreated due to the danger
that the tendon can become weak, frayed, thickened, and eventually it may rupture.
Your physiotherapist or sports doctor can usually confirm the diagnosis of Achilles tendonitis in the clinic. They will base their diagnosis on your history, symptom behaviour and clinical tests.
Achilles tendons will often have a painful and prominent lump within the tendon. Further investigations include US scan or MRI. X-rays are of little use in the diagnosis.
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.?
Chronic Achilles tendon tears can be more complicated to repair. A tendon that has torn and retracted (pulled back) into the leg will scar in the shortened position over time. Restoring normal tendon
length is usually not an issue when surgery is performed within a few weeks of the injury. However, when there has been a delay of months or longer, the treatment can be more complicated. Several
procedures can be used to add length to a chronic Achilles tear. A turndown procedure uses tissue folded down from the top of the calf to add length to the Achilles tendon. Tendon transfers from
other tendons of the ankle can also be performed to help restore function of the Achilles. The results of surgery in a chronic situation are seldom as good as an acute repair. However, in some
patients, these procedures can help restore function of a chronically damaged Achilles.
A 2014 study looked at the effect of using foot orthotics on the Achilles tendon. The researchers found that running with foot orthotics resulted in a significant decrease in Achilles tendon load
compared to running without orthotics. This study indicates that foot orthoses may act to reduce the incidence of chronic Achilles tendon pathologies in runners by reducing stress on the Achilles
tendon1. Orthotics seem to reduce load on the Achilles tendon by reducing excessive pronation,